Rheumatoid Arthritis and Risk of Atrial Fibrillation: Results from Pooled Cohort Studies and Mendelian Randomization Analysis

Abstract

Observational research has indicated that individuals diagnosed with rheumatoid arthritis (RA) have an elevated likelihood of developing atrial fibrillation (AF). Herein, we performed meta-analysis and Mendelian randomization (MR) analysis to explore the correlation and potential causal relationship between RA and AF. We searched PubMed, Embase, and Web of Science for cohort studies comparing AF risk among participants with and without RA. Quantitative synthesis of the adjusted risk ratio (RR) or hazard ratio was performed with the random-effects model. RA and AF were studied with two-sample MR analysis with the random-effects inverse variance weighted method. Patients with RA had a higher risk of AF than participants without RA [RR = 1.32, 95% confidence interval (CI): 1.23–1.43, P < 0.0001]. Genetically predicted RA was not associated with a significantly elevated risk of AF (odds ratio = 1.009, 95% CI: 0.986–1.032, P = 0.449). After adjustment for confounding factors in multifactorial MR, RA and AF still showed no correlation. Sensitivity analyses yielded similar results, thus indicating the robustness of the causal association. Overall, RA was associated with elevated risk of AF in our meta-analysis. However, genetically predicted RA may not be causal.