Schmidt SAJ, Olsen M, Schmidt M, Vestergaard C, Langan SM, Deleuran MS, Riis JL

Journal of the American Academy of Dermatology (2019)

Background: Atopic dermatitis is characterized by chronic inflammation, which is a
risk factor for atrial fibrillation.

Objective: To examine the association between hospital-diagnosed atopic dermatitis
and atrial fibrillation.

Methods: Using linked population-based Danish registries, we identified persons with
an in- or out-patient hospital diagnosis of atopic dermatitis during 1977–2013 and an
individually-matched comparison cohort. We followed cohorts until death, emigration,
atrial fibrillation diagnosis or until 2013. We compared 35-year risk of atrial fibrillation
and estimated hazard ratios with 95% confidence intervals (CIs) using Cox regression,
adjusting for birth year and sex. We validated 100 atopic dermatitis diagnoses from a
dermatological department through medical record review.

Results: We included 13,126 persons with atopic dermatitis and 124,211 comparators
followed for a median of 19.3 years. The 35-year risk of atrial fibrillation was 0.81%
and 0.67%, respectively. The positive predictive value of atopic dermatitis diagnoses
was 99%. The hazard ratio was 1.2 (95% CI: 1.0–1.6) and remained increased after
adjusting for various atrial fibrillation risk factors.

Limitations: Limited to moderate-to-severe atopic dermatitis and no lifestyle data.

Conclusions: Patients with hospital-diagnosed atopic dermatitis have a 20% increased
long-term risk of atrial fibrillation, but the absolute risk remains low.