The risk of atrial fibrillation is higher in depressed people

Depressed people have an increased risk of atrial fibrillation, according to one study ("Depression, Antidepressants and Risk of Non-Valve Atrial Fibrillation: A Danish Paired Cohort Study") published in European Journal of Preventive Cardiology. Researchers are not responsible for the high frequency of atrial fibrillation in depressed people.

"It is common knowledge that there is a connection between the mind and the heart. Depression predicts the development of coronary heart disease and worsens its prognosis. Our study examined whether depression is also related to atrial fibrillation, "says the study's author, Morten Fenger-Grøn, Senior Statistician, General Medicine Research Unit, University of Aarhus , Denmark.

Atrial fibrillation is the most common cardiac arrhythmia. It causes 20-30% of all strokes and increases the risk of premature death. Previous studies have shown associations between depression and more severe symptoms and higher mortality in patients with atrial fibrillation. Antidepressants have been associated with serious but rare heart rhythm disorders, which raises the question of whether they could also increase the risk of atrial fibrillation.

This study examined the association between depression and antidepressant treatment and the risk of developing atrial fibrillation. Completing a prescription for anti-depressants for the first time was used as an indicator of depression.

"Depression is associated with an increased risk of developing a series of cardiovascular diseases and an increased burden of symptoms in patients with atrial fibrillation. The purpose of this study was to determine the link between depression, antidepressant treatment and the risk of incident atrial fibrillation.

"A national registry-based study comparing the risk of atrial fibrillation among all Danes who started antidepressant treatment from 2000 to 2013 (N7785 254) with that of a 1/1 sample of the generally matched population.

"Cox regression was used to estimate adjusted risk ratios (HRs) and associated 95% confidence intervals (95% CI), both after treatment initiation and the previous month, when patients were expected to have untreated depression medically.

"Antidepressant treatment was associated with a threefold higher risk of atrial fibrillation in the first month (HR 3.18 (95% CI: 2.98-3.39)). This association was gradually attenuated during the following year (aHR1,37 (95% CI: 1,31-1,44) 2-6 months after the start of antidepressant treatment, and HR1,11,12 (95% CI: 1.06-1.16) 6-12 months after). However, the risk associated with atrial fibrillation was even higher the month before the start of antidepressant treatment (7 HRh 7.65 (95% CI: 7.05 to 8.30) 30 to 15 days before and 4.29 HR (95% CI: 3.94-4.67), previous 15 days). Overall, atrial fibrillation was diagnosed in 0.4% of patients 30 days before and 30 days after antidepressant treatment.

"Antidepressant users had a significantly increased risk of atrial fibrillation, especially before the start of treatment. Whether this reflects a cause-and-effect relationship between depression and atrial fibrillation can have important implications for public health and needs to be discussed. "

"The execution of a prescription for antidepressants, which we used as an indicator of depression, was associated with a threefold higher risk of atrial fibrillation. Decreasing over time may suggest that treatment could mitigate this risk, "says Fenger-Grøn.

The risk of atrial fibrillation was even higher one month before the start of antidepressant treatment. "This suggests that antidepressants are not associated with the development of atrial fibrillation," he continues. "If you are depressed, there is no reason to fear that a drug treatment is causing atrial fibrillation."