Risk of incident atrial fibrillation in patients with rheumatoid arthritis: a systematic review and meta‐analysis

Aims Patients with rheumatoid arthritis ( RA ) might be at an increased risk of developing atrial fibrillation ( AF ) as a result of deleterious effects of inflammatory cytokines on cardiomyocytes. This study aimed to comprehensively review all available evidence to further characterize this possible association. Methods We conducted a systematic review and meta‐analysis of cohort studies that reported relative risk, hazard ratio, incidence ratio or standardized incidence ratio with 95% confidence intervals comparing the risk of incidence of AF in patients with RA versus non‐ RA participants. Pooled risk ratio and 95% confidence interval were calculated using random‐effect, generic inverse‐variance methods of DerSimonian and Laird. Results Three retrospective cohort studies with 39 912 cases of RA and 4 269 161 non‐ RA controls were included in the data analysis. The pooled risk ratio of subsequent development of AF in patients with RA versus controls was 1.29 (95% CI , 1.05–1.59). The statistical heterogeneity was moderate with an I 2 of 71%. Conclusion Our meta‐analysis demonstrated a statistically significant increased risk of subsequent development of AF among patients with RA .