Asthma Linked to Increased Risk of Developing AFib

Matthew Tattersall, DO

A recent analysis of more than 6,500 patients from 6 sites across the US is revealing more about a possible link between having asthma and a person’s risk for developing a common heart rhythm disorder.

Results of the study indicate people with persistent asthma could be at a 1.5 times greater risk of developing atrial fibrillation (AFib) later in life compared to individuals without asthma.

"Being aware there is this association means we need to help patients focus on these primary prevention things we know we should be doing but that are often the hardest things to do," said Matthew Tattersall, DO, an assistant professor of cardiovascular medicine at the University of Wisconsin in Madison. "But they can help with asthma and they can also reduce risk for atrial fibrillation."

Using data obtained from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort, Tattersall and a team of colleagues from the University of Washington and the Medical University of South Carolina conducted a retrospective analysis with the goal of identifying an association between persistent asthma and the risk for developing AFib. From the MESA study, a cohort of 6,615 individuals was identified for inclusion in the current analysis.

Participants in the MESA study were all free of known cardiovascular disease at baseline and had the presence of asthma determined at the first exam of the study. Participants were followed for a median of 12.9 years of follow-up for the development of AFib.

For the analysis, persistent asthma was defined as those with asthma on controller medications and intermittent asthma was defined as those with asthma not taking controller medications. Ascertainment of AFib diagnoses were done through 12-lead ECGs performed at study exams, hospital discharge diagnoses odes of AFib, or through Medicare claims data.

Covariates included in the current analysis included diabetes mellitus, smoking status, alcohol consumption, education, presence of sleep apnea, and blood pressure, among others. Multivariable Cox regression models were used by investigators to assess potential associations of asthma subtype with AFib.

Among non-asthmatics, the rate of AFib was 0.11 events per 10 person-years. In comparison, the rate for intermittent and persistent asthmatics was 0.11 (95% CI, 0.08-0.14) and 0.19 (95% CI, 0.12-0.49) per 10-person years, respectively (log-rank P=0.008). Adjusted models, indicated persistent asthmatics were at a greater risk of incident AFib (HR 1.49; 95% CI, 1.03-2.14, P = 0.03).

Interleukin 6 (HR 1.26; 95% CI, 1.13-1.42), tumor necrosis-α receptor 1 (HR 1.09; 95% CI, 1.08-1.11), and D-Dimer (HR 1.10; 95% CI 1.02-1.20) were found to be predictors of incident AFib based on the results of the analyses, but investigators noted the apparent relationship between asthma and incident AFib was not diminished by adjustment for any of the aforementioned inflammation markers or fibrinogen.

This study, “Persistent Asthma is Associated with Increased Risk for Incident Atrial Fibrillation in the Multi-Ethnic Study of Atherosclerosis (MESA),” was published online in Circulation: Arrhythmia and Electrophysiology.