Review of mental disorders and atrial fibrillation risk

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Published studies have shown that mental disorders are common risk factors for cardiovascular disease (CVD); However, according to Hao Wu and colleagues, the relationship between psychological factors and atrial fibrillation remains unclear. They conducted a meta-analysis and concluded that “adverse psychological factors such as anxiety, anger, depression and work stress may increase the risk of atrial fibrillation”.

The study, published in the International Journal of Cardiology, collected articles from PubMed, Embase, Web of Science, and Cochrane Library databases up to January 2022. The researchers used random-effects and fixed-effects models to calculate pooled hazard ratios (HRs). The Newcastle-Ottawa Scale (NOS) was also used to assess risk of bias in non-randomised studies.

Mental Disorders and Atrial Fibrillation Outcomes

Among 13 published reports including 5,329,908 participants, the authors found that the incidence of atrial fibrillation increased by:

  • 10% (RR, 1.10; 95% CI, 1.02-1.19; I2 = 33.6%; P=.013; n = 235,599 in 6 studies) for anxious patients
  • 15% (RR, 1.15; 95% CI, 1.04-1.26; I2 = 40.2%; P=.04; n = 21,791 in 3 studies) for patients with anger
  • 25% (RR, 1.25; 95% CI, 1.12-1.39; i2 = 57.4%; P<.001 n="5,160,247" in studies for patients with depression>
  • 18% (RR, 1.18; 95% CI, 1.05-1.32; I2 = 19.2%; P=.004; n = 51,664 in 4 studies) for work-stressed patients

The authors proposed that “interventions aimed at preventing mental disorders could reduce the growing global burden of atrial fibrillation and associated healthcare costs.” They also stated that, “given the limitations of the current study, our results need to be confirmed by a larger prospective study.”

Find more recent studies on the Atrial Fibrillation Knowledge Center

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