Key result
Asthma is linked to a ~15% increased risk of atrial fibrillation.
Why the study?
Respiratory disease and AF frequently coexist, but the risk of AF among asthma patients is less characterized.
Does asthma increase the risk of atrial fibrillation in a general population?
Meta-Analysis (n=1,405,508)
Does asthma increase the risk of atrial fibrillation in a general population?
Odds Ratio: 1.15 (95% CI 1.01–1.29)
p-value: p=0.02
Asthma is associated with a modestly increased risk of incident atrial fibrillation, though the evidence is limited by high heterogeneity and observational bias.
Asthma may modestly raise AF risk but should not change practice; leaves open causality amid very low-certainty observational data.
Respiratory disease and atrial fibrillation (AF) frequent coexist, but the risk of AF among asthma patients is less characterized. Growing evidence suggest that AF shares with asthma a systemic inflammation background and asthma treatments, such as beta agonists, have been associated with increased risk of cardiac arrhythmias. The aim of this systematic review was to assess the risk of AF in patients with asthma in observational studies. We search for longitudinal studies reporting AF outcome in asthma and control patients through MEDLINE, Cochrane Central Register of Controlled Trials and EMBASE. Pooled estimates of odds ratios (ORs) and 95% confidence intervals (CIs) were derived by random effects meta-analysis. Heterogeneity was assessed using the I2 test. The risk of bias of individual studies was evaluated using the ROBINS-E tool. The study protocol was registered at PROSPERO: CRD42020215707. Seven cohort/nested case–control studies with 1 405 508 individuals were included. The mean follow-up time was 9 years, ranging from 1 to 15 years. Asthma was associated with a higher risk of AF (OR 1.15. 95% CI 1.01–1.29). High heterogeneity (I 2 = 81%) and overall “serious” risk of bias, lead to a very low confidence in in this result. Asthma was associated with an increased risk of AF. However, the high risk of bias and high heterogeneity reduces the robustness of these results, calling for further high-quality data.
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Nogueira-Garcia et al. (2024) conducted a meta-analysis in Asthma (n=1,405,508). Asthma vs. Matched controls without asthma was evaluated on Risk of atrial fibrillation (OR 1.15, 95% CI 1.01-1.29, p=0.02). Asthma was associated with a significantly increased risk of atrial fibrillation compared to matched controls (OR 1.15), though the certainty of evidence was very low.
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