Corticosteroids and the Risk of Atrial Fibrillation

Hooft, C; Heeringa, Jan; Brusselle, Guy; Hofman, Albert; Witteman, Jacqueline C. M.; Kingma, J. Herre; Sturkenboom, Miriam; Stricker, Bruno H. Ch.

doi:10.1001/archinte.166.9.1016

Cited by 152 publications

(94 citation statements)

References 30 publications

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“…In a population based, case control study current glucocorticoid use was associated with an increased risk of AF or AFL compared with never use (adjusted OR, 1.92; 95% confidence interval [CI], 1.79-2.06) while among new glucocorticoid users; the adjusted OR was 3.62 (95% CI, 3.11-4.22) (15). In another case control study by van der Hooft et al, findings strongly showed that patients receiving high-dose corticosteroid therapy, not uncommon in the treatment of COPD, are at increased risk of developing atrial fibrillation [31]. Huerta et al showed that inhaled steroids were not associated with an increased risk of AF or arrhythmias while theophylline and oral steroids were associated with an increased risk of arrhythmias especially AF [32].…”

Section: Copd Treatment Causing Afmentioning

confidence: 98%

The Association between Chronic Obstructive Pulmonary Disease (COPD) and Atrial Fibrillation: A Review

Shah¹,

Desai²

2017

Chron Obstruct Pulmon Dis

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COPD is one of the leading causes of Mortality & Morbidity in the US and is associated with a wide variety of cardiovascular diseases especially arrhythmias, angina, myocardial infarction and congestive heart failure and is directly associated with the severity of COPD described in the GOLD initiative. COPD is an independent risk factor for AF/AFL. Smoking, hypoxia and inflammation all contribute to AF in COPD patients mainly via atrial remodeling while hypercapnia contributes to it via increasing refractoriness of the atrial musculature and a delay in the return of the refractoriness to normal after resolution of the hypercapnia. The most common EKG abnormality found in patients with COPD is P pulmonale and the PQ interval is the strongest predictor of developing AF. The P wave Dispersion (PwD) was also an independent risk factor for the development of AF and was found to be more in the acute phase than in the stable phase.The BODE index, an important prognostic score among patients hospitalized with a COPD exacerbation has a direct co relation with the prevalence of AF/AFL while the DECAF score, which was found to be superior to the CURB 65 score as a mortality predictor for hospitalized patients, includes AF as one of the criteria. Chronic hypoxemia is one of the main reasons for altered pulmonary vein anatomy and hence the presence of COPD was identified as an independent risk factor for the recurrence of atrial tachyarrhythmias after catheter ablation in patients with COPD and the absence of COPD was also found to be an independent predictor for a successful electrocardioversion. These patients were also found to have an increased incidence of non-PV foci for the arrhythmias. Oral glucocorticoids were associated with an increased risk of developing AF especially high dose steroids. It is recommended to correct the underlying respiratory decompensation while treating patients with AF as they render the treatment of AF ineffective. Nondihydropyridine calcium channel blockers should be used as first line rate control agents for AF in patients with concomitant COPD while the β-blockers, sotalol, propafenone can be used in patients with obstructive lung disease who do not have bronchospasm.

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Section: Copd Treatment Causing Afmentioning

confidence: 98%

The Association between Chronic Obstructive Pulmonary Disease (COPD) and Atrial Fibrillation: A Review

Shah¹,

Desai²

2017

Chron Obstruct Pulmon Dis

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“…27 A metaanalysis of RCTs found the risk of postoperative AF was reduced by 50% by the use of perioperative corticosteroids. 28 A population-based case-control study in Denmark with over 20 000 cases and 200 000 controls 29 found that current glucocorticoid use, but not past use, was associated with an almost twofold increased risk of AF or flutter, supporting the findings of two much smaller case-control studies in the Netherlands 30 and the UK. 31 …”

Section: Resultsmentioning

confidence: 71%

Predictors of incident atrial fibrillation and influence of medications: a retrospective case–control study

2011

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“…The target and predictor variables including demographic and clinical characteristics among the risk factors for AF were given in detail (Table 1). 7,8 …”

Section: Datasetmentioning

confidence: 99%

Investigating Optimal Number of Cross Validation on the Prediction of Postoperative Atrial Fibrillation by Voting Ensemble Strategy

Çolak¹,

Çolak²,

Erdil³

et al. 2016

Turkiye Klinikleri J Biostat

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Objective: Atrial fibrillation (AF) is the most widely recognized cardiovascular arrhythmia. Symptomatic AF can decrease quality of life, functional condition, and performance of the heart. In order to make a clinical decision strategy, the present study attempts to investigate the optimal number of cross validation (CV) [NOCV] on the prediction of postoperative AF based on the several data mining and voting ensemble approaches. Material and Methods: The retrospective dataset included complete medical records of 2888 individuals after coronary artery bypass grafting. The subjects were divided into two groups: AF group (n=360) and non-AF group (n=2528), respectively. Data mining approaches including artificial neural networks (ANN), Naïve Bayes (NB) and logistic regression (LR) were constructed for the prediction of the presence or absence of AF. Additionally, voting ensemble strategy was employed in order to improve predictive accuracy. NOCV was optimized by Grid search. For evaluating the predictive performance, accuracy and area under curve (AUC) of the receiver operating characteristics (ROC) graph were considered as evaluation index. Results: After removing the missing values and outliers, this research consisted of 2694 subjects; 327 (12.1%) in AF group and 2367 (87.9%) in non-AF group, respectively. The largest accuracy of 87.8% for LR was observed in the 8-fold CV. Similarly, voting ensemble yielded the highest AUC value of 0.896 in the 10-fold CV. The highest accuracy and AUC were 87.2% and 0.896 for voting, 87.8% and 0.729 for LR, 87.1% and 0.668 for ANN, and 79.4% and 0.675 for NB, consecutively. Conclusion: The results of the current research demonstrated that the constructed models yielded different results for predicting postoperative AF in the determination of the optimal NOCV. It is recommended to determine the optimal NOCV by optimization techniques. The proposed voting was an acceptable and promising approach for predicting AF, and thence, can support clinicians in the clinical decision making.

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Corticosteroids and the Risk of Atrial Fibrillation

Cited by 152 publications

References 30 publications

The Association between Chronic Obstructive Pulmonary Disease (COPD) and Atrial Fibrillation: A Review

The Association between Chronic Obstructive Pulmonary Disease (COPD) and Atrial Fibrillation: A Review

Predictors of incident atrial fibrillation and influence of medications: a retrospective case–control study

Investigating Optimal Number of Cross Validation on the Prediction of Postoperative Atrial Fibrillation by Voting Ensemble Strategy

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