RESEARCH - Corticosteroids and the risk of atrial fibrillation

[Guest guest]

Arch Intern Med. 2006;166:1016-1020

Corticosteroids and the Risk of Atrial Fibrillation

Cornelis S. van der Hooft, MD; Jan Heeringa, MD; Guy G. Brusselle, MD,

PhD; Albert Hofman, MD, PhD; C. M. Witteman, PhD; J. Herre

Kingma, MD, PhD; Miriam C. J. M. Sturkenboom, PharmD, PhD; Bruno H.

Ch. Stricker, MB, PhD

..

ABSTRACT

Background High-dose (pulse) corticosteroid therapy has been

associated with the development of atrial fibrillation. This

association, however, is mainly based on case reports.

Methods To test the hypothesis that high-dose corticosteroid exposure

increases the risk of new-onset atrial fibrillation, we performed a

nested case-control study within the Rotterdam Study, a

population-based cohort study among 7983 older adults. Cases were

defined as persons with incident atrial fibrillation between July 1,

1991, and January 1, 2000. Their date of diagnosis was defined as the

index date. All noncases within the Rotterdam Study who were alive and

eligible on this index date were used as controls. Subsequently, we

compared the proportion of cases and controls that received a

corticosteroid prescription within 1 month preceding the index date.

Corticosteroid exposure was categorized into high-dose exposure (oral

or parenteral steroid at a daily dose 7.5 mg of prednisone

equivalents) and low-intermediate–dose exposure (<7.5 mg of prednisone

equivalents or inhaled corticosteroids).

Results There were 385 eligible cases of new-onset atrial

fibrillation during the study period. The risk of new-onset atrial

fibrillation was significantly higher for persons who received a

corticosteroid prescription within 1 month before the index date than

for those without (odds ratio [OR], 3.75; 95% confidence interval

[CI], 2.38-5.87). However, only high-dose corticosteroid use was

associated with an increased risk (OR, 6.07; 95% CI, 3.90-9.42),

whereas low-intermediate–dose use was not (OR, 1.42; 95% CI,

0.72-2.82). The association of atrial fibrillation with high-dose

corticosteroid use was largely independent of the indication for

corticosteroid therapy, since the risk of new-onset atrial

fibrillation was not only increased in patients with asthma or chronic

obstructive pulmonary disease (OR, 4.02; 95% CI, 2.07-7.81) but also

in patients with rheumatic, allergic, or malignant hematologic

diseases (OR, 7.90; 95% CI, 4.47-13.98).

Conclusion Our findings strongly suggest that patients receiving

high-dose corticosteroid therapy are at increased risk of developing

atrial fibrillation.

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Read the entire article here:

http://archinte.ama-assn.org/cgi/content/full/166/9/1016

Not an MD

[Guest guest]

Well, this gives me a little more reason to keep going down on the

Prednisone. Last night when I filled my pill boxes, I dropped from 5 mg to 4

mg! Still going down a bit at a time. It's not too bad now, but my back is

trying to tell me to go up instead of down. I might have to get more

injections in it soon.

Dennis in eastexas

On Sun, Oct 26, 2008 at 1:15 PM, <

Rheumatoid.Arthritis.Support@...> wrote:

> Arch Intern Med. 2006;166:1016-1020

>

>

> Corticosteroids and the Risk of Atrial Fibrillation

>

>

>

[Guest guest]

Hang in there, Dennis! I wish you success!

Sue

On Sunday, October 26, 2008, at 09:20 PM, Dennis W wrote:

> Well, this gives me a little more reason to keep going down on the

> Prednisone. Last night when I filled my pill boxes, I dropped from 5

> mg to 4

> mg! Still going down a bit at a time. It's not too bad now, but my

> back is

> trying to tell me to go up instead of down. I might have to get more

> injections in it soon.

[Guest guest]

Good luck, Dennis.

I'm sure this can't be easy for you since you have been on prednisone

for so long. You've made a lot of progress.

Not an MD

On Sun, Oct 26, 2008 at 9:20 PM, Dennis W <betnden@...> wrote:

> Well, this gives me a little more reason to keep going down on the

> Prednisone. Last night when I filled my pill boxes, I dropped from 5 mg to 4

> mg! Still going down a bit at a time. It's not too bad now, but my back is

> trying to tell me to go up instead of down. I might have to get more

> injections in it soon.

>

> Dennis in eastexas