Secondhand smoke and atrial fibrillation: Data from the Health eHeart Study - PubMed (original) (raw)

Secondhand smoke and atrial fibrillation: Data from the Health eHeart Study

Shalini Dixit et al. Heart Rhythm. 2016 Jan.

Abstract

Background: Cigarette smoking is a risk factor for atrial fibrillation (AF), but whether secondhand smoke (SHS) impacts the risk of AF remains unknown.

Objective: To determine if SHS exposure is associated with an increased risk of AF.

Methods: We performed a cross-sectional analysis of data from participants enrolled in the Health eHeart Study, an internet-based, longitudinal cardiovascular cohort study, who completed baseline SHS exposure and medical conditions questionnaires. SHS was assessed through a validated 22-question survey, and prevalent AF was assessed by self-report, with validation of a subset (n = 42) by review of electronic medical records.

Results: Of 4976 participants, 593 (11.9%) reported having AF. In unadjusted analyses, patients with AF were more likely to have been exposed to SHS in utero, as a child, as an adult, at home, and at work. After multivariable adjustment for potential confounders, having had a smoking parent during gestational development (OR 1.37, 95% CI 1.08-1.73, P = .009) and residing with a smoker during childhood (OR 1.40, 95% CI 1.10-1.79, P = .007) were each significantly associated with AF. Both positive associations were more pronounced among patients without risk factors for AF (P values for interaction <.05).

Conclusions: SHS exposure during gestational development and during childhood was associated with having AF later in life. This association was even stronger in the absence of established risk factors for AF. Our findings indicate that SHS in early life may be an important, potentially modifiable risk factor for the development of AF.

Keywords: Arrhythmia; Atrial fibrillation; Epidemiology; Lone atrial fibrillation; Prevention; Risk factors; Secondhand smoke.

Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

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Conflict of interest statement

Conflicts of interest: Dr. Marcus has received research support from the NIH, PCORI, SentreHeart, Medtronic and Pfizer and is a consultant for and holds equity in InCarda.

Figures

Figure 1

Figure 1

Summary of secondhand smoke exposures in those with and without atrial fibrillation. Values are reported as percentages for yes/no questions and medians for numeric responses. Y error bars denote interquartile ranges. Questions are limited to a priori selected criteria (see text).

Figure 2

Figure 2

Odds ratios for atrial fibrillation by secondhand smoke exposure. The odds ratios for atrial fibrillation (black square) after adjusting for age, sex, race, smoking status, years of smoking, alcohol consumption, diabetes, hypertension, coronary artery disease, and congestive heart failure. Y error bars denote 95% confidence intervals.

Figure 3

Figure 3

Odds ratios for atrial fibrillation stratified by the presence of cardiovascular risk factors. The adjusted odds ratios for the associations between secondhand smoke and atrial fibrillation, stratified by the presence (grey square) or absence (white square) of at least one of the following risk factors: age >60, diabetes mellitus (DM), hypertension (HTN), coronary artery disease (CAD), or congestive heart failure (CHF). Odds ratios are adjusted for age, sex, race, smoking status, years of smoking, alcohol consumption, DM, HTN, CAD, and CHF. Y error bars denote 95% confidence intervals.

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