Abstract 11217: Association of Hepatitis C infection and Incident Atrial Fibrillation

Abstract

Introduction: Prior studies have shown that HIV infection is associated with incident atrial fibrillation (AF). Anecdotal evidence suggests that patients with Hepatitis C virus (HCV) infection may also be at increased risk of AF at a young age. Hypothesis: We postulate that HCV infection increases the risk of incident AF. Methods: We performed a case-control study using administration data from the Veterans Health Administration. ‘Case’ patients included 103876 VA patients newly diagnosed with HCV during 2005-2013; patients with no use of VA services during the year prior to HCV diagnosis and patients with pre-existing AF were excluded. Each ‘case’ patient was matched to a single patient without HCV or AF. Patients were matched by age, race, gender, prior use of VA services, hypertension, sleep apnea, and other AF risk factors. Cox proportional hazards regression was used to define the association between HCV infection and incident AF. Results: The HCV and control groups were well matched by demographics and co-morbidities. The average follow-up period was 4.3 years. Among patients with HCV, 4087 (3.9%) patients were diagnosed with incident AF; 3185 (3.1%) patients without HCV were diagnosed with incident AF. Overall, the rate of new AF diagnosis per 10 patient-years of follow-up was 9.7% and 6.8% for patients with and without HCV, respectively. In Cox proportional hazards regression models, the relative hazard of AF was 1.42 times higher (95% CI, 1.35-1.48; p<0.001) for patients with HCV compared to those without. Conclusions: HCV infection appears to be associated with an increased risk of developing AF. Possible mechanisms include chronic systemic inflammation associated with HCV infection or direct cardiotoxic effects of the virus. It is unknown whether the use of new curative medications to eradicate HCV will reduce the incident risk of AF in these patients.