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Objectively confirmed gastroesophageal reflux disease and risk of atrial fibrillation: A population-based cohort study in Sweden

Research output: Contribution to journalArticlepeer-review

John Maret-Ouda, Giola Santoni, Shaohua Xie, Annika Rosengren, Jesper Lagergren

Original languageEnglish
Pages (from-to)1116-1120
Number of pages5
JournalEuropean Journal of Gastroenterology and Hepatology
Issue number11
Accepted/In press29 Jun 2022
Published1 Nov 2022

Bibliographical note

Funding Information: This study was funded by the Swedish Research Council (Grant numbers 2019-00209 and 2018-2527). Publisher Copyright: © 2022 Lippincott Williams and Wilkins. All rights reserved.

King's Authors


Objective This study aimed to determine the risk of atrial fibrillation in patients with objectively confirmed GERD. Methods This was a nationwide population-based cohort study between 2005 and 2018, including the majority (n = 8 421 115) of all Swedish adult residents (≥18 years). Within this cohort, the exposed group were all individuals with a diagnosis of esophagitis or Barrett's esophagus, and the unexposed group was made up of five times as many individuals without any GERD, matched by age, sex, and calendar year. The outcome was the first diagnosis of atrial fibrillation. Cox regression provided hazard ratios (HRs) with 95% confidence intervals (CIs), adjusted for confounders. Results Among 118 013 individuals with esophagitis or Barrett's esophagus and 590 065 without GERD, 7042 (6.0%) and 40 962 (6.9%) developed atrial fibrillation, respectively. The risk of atrial fibrillation among patients with GERD was 13% increased within the first year of diagnosis (HR, 1.13; 95% CI, 1.06-1.20), but was not increased after that. Among individuals aged less than 60 years, the HR of atrial fibrillation was 55% increased within the first year of diagnosis (HR, 1.55; 95% CI, 1.27-1.88), and this association remained increased after the first year (HR, 1.14; 95% CI, 1.06-1.22). No association was found in older participants (≥60 years). Results were similar in men and women. Conclusion This large population-based cohort study indicates that objectively determined GERD increases the risk of atrial fibrillation shortly after diagnosis in men and women younger than 60 years.

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