Abstract
Background: Gallstone disease (GD) is associated with a high risk of cardiovascular disease. However, it is unknown whether GD contributes to atrial fibrillation (AF). We aimed to investigate the association between GD and AF.Methods: We performed a population-based cohort study using data from the Taiwan National Health Insurance Research Database between 2001 and 2011. A GD cohort of 230,076 patients was compared with a control cohort consisting of an equal number of patients matched for age, sex, cardiovascular and gastrointestinal comorbidities.Results: In total, 5,992 (49.8/10,000 person-years) patients with GD and 5,804 (44.5/10,000 person-years) controls developed AF. GD increased AF risk with a hazard ratio (HR) of 1.20 [95% confidence interval (CI), 1.16–1.25]. In patients with GD but without cholecystectomy, the HR of AF reached 1.57 (95% CI = 1.50–1.63). After cholecystectomy, the HR of AF significantly decreased to 0.85 (95% CI = 0.81–0.90). Among the three age groups with GD (<45, 45–64, and ≥65 years), the adjusted HRs of AF were 1.59 (95% CI = 1.08–2.33), 1.31 (95% CI = 1.18–1.45), and 1.18 (95% CI = 1.13–1.22), respectively. Compared with patients with a CHA2DS2-VASc score equal to 0, the HRs of AF risk among total cohort patients and a score equal to 1, 2, 3, and ≥ 4 were 1.28 (95% CI = 1.15–1.43), 2.26 (95% CI = 2.00–2.56), 3.81 (95% CI = 3.35–4.34), and 5.09 (95% CI = 4.42–5.87), respectively.Conclusion: This population-based longitudinal follow-up study showed that patients with GD had an increased AF risk. Moreover, cholecystectomy was related to reduced AF risk. Cardiovascular checkups may be necessary for patients with GD, especially those who are young and have other typical risk factors.
Highlights
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults
AF prevalence varies among ethnic populations, its prevalence progressively increases with advancing age
This study demonstrated that Gallstone disease (GD) was independently associated with an increased AF risk in a population-based cohort, suggesting that GD may play a crucial role in determining AF risk
Summary
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults. AF prevalence varies among ethnic populations, its prevalence progressively increases with advancing age. It occurs in 80 years (Kannel and Benjamin, 2009; Rodriguez et al, 2015). Up to 90% of AF events may be symptomless, in the elderly (Page et al, 1994). Early recognition and diagnosis of AF are crucial, in people with risk factors (RFs). Gallstone disease (GD) is associated with a high risk of cardiovascular disease. It is unknown whether GD contributes to atrial fibrillation (AF). We aimed to investigate the association between GD and AF
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