International Journal of Cardiology 171 (2014) e46
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Letter to the Editor
Risk factors for new-onset atrial ﬁbrillation Sevket Balta a,⁎, Ertugrul Kurtoglu b, Mustafa Demir a, Sait Demirkol a, Zekeriya Arslan a, Murat Unlu a a b
Department of Cardiology, Gulhane Medical Academy Ankara, Turkey Department of Cardiology, Malatya State Hospital, Malatya, Turkey
a r t i c l e
i n f o
Article history: Received 5 September 2013 Accepted 30 November 2013 Available online 6 December 2013 Keywords: Atrial ﬁbrillation Risk factors Serum potassium
Dear Editor, We have read with great enthusiasm the recently published article entitled “Serum potassium levels and the risk of atrial ﬁbrillation” by Krijthe and coworkers . In that very well-designed and presented study Krijthe and coworkers tried to investigate the association of serum potassium and the risk of atrial ﬁbrillation in a population based setting. They concluded that low serum levels of potassium were associated with a higher risk of atrial ﬁbrillation. Atrial ﬁbrillation contributes to substantial increases in morbidity and mortality, and is expected to affect millions of people worldwide. AF is responsible for considerable morbidity and mortality, making identiﬁcation of modiﬁable risk factors a priority. Left atrium (LA) enlargement has an important role of increased risk in AF. The higher risk of AF is also associated with age besides LA enlargement . The presence of an unrecognized MI was associated with a double increased risk of atrial ﬁbrillation in men, independent of known cardiovascular risk factors . On the other hand, elevated transaminase concentrations are related to increased risk of AF . Also, hyperthyroidism is a relative uncommon but important cause of atrial ﬁbrillation . Additionally, in the previous large population-based study, greater levels of serum phosphorus were associated with an increased risk of AF . Hyperuricemia was also associated with several cardiovascular diseases. Elevated serum level of uric acid was associated with an
⁎ Corresponding author at: Department of Cardiology, Gulhane School of Medicine, Tevﬁk Saglam St., Etlik, 06018 Ankara, Turkey. Tel.: + 90 312 3044281; fax: +90 312 3044250. E-mail address: [email protected]
(S. Balta). 0167-5273/$ – see front matter © 2013 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.ijcard.2013.11.115
increased systemic inﬂammation. Hyperuricemia was a signiﬁcant risk factor of new-onset AF based on inﬂammation . There is an increasing body of literature in which the authors showed the pleiotropic effects of statin therapy in relation to AF. Statin treatment is associated with a lower prevalence and incidence of AF after adjustment for potential confounders . Some medications such as bisphosphonate increased the risk of AF . Another interesting study aimed at investigating whether or not exposure to non-steroidal anti-inﬂammatory drugs (NSAID) was a risk factor for AF. They found that recent NSAID use may predispose patients to AF . In conclusion, low serum levels of potassium were associated with a higher risk of atrial ﬁbrillation as presented in the current study. However risk factors for incident AF are very complex  and the principal roles of those risk factors deserve further large-scale prospective randomized clinical trials.
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