Background: The association between atrial fibrillation (AF) and inflammation has been established. Diabetes mellitus (DM) is associated with increase inflammation and is an independent important risk factor of AF. Moreover, rhinosinusitis is an inflammation of the paranasal sinuses and nasal cavity. However, the association of rhinosinusitis as a risk factor of AF is unknown. The present study aimed to examine the association between rhinosinusitis, DM and AF.

Methods: A total of 229,100 patients with the diagnosis of rhinosinusitis were identified as the study cohort from the Taiwan National Health Insurance Research Database from January 1, 2001, through December 31, 2012. The comparison cohort consisted of patients without rhinosinusitis and were match for age and sex with the study cohort at a ratio of 1:1. Incidence and hazard ratio (HR) of AF were calculated by Multivariable Cox regression models.

Results: The incidence rate of AF was 142.4 per 10,000 person-years (95% CI 136.8-148.0) for the study cohort and 116.5 (95% CI 111.4-121.6) for the comparison cohort. Adjusted HR was 1.17 (95% CI 1.11-1.25) for the total study cohort, 1.18 (95% CI 1.11-1.25) for patients with acute sinusitis and 1.14 (95% CI 1.00-1.31) for chronic sinusitis. In subgroup analysis, HR for patients with DM was 1.23 (95% CI 1.09-1.39) for total study cohort, 1.20 (95% CI 1.06-1.37) for acute sinusitis and 1.44 (95% CI 1.13-1.84) for chronic sinusitis. The risk was less significant for patients with metformin use more than 28 days. HR 1.09 (95% CI 0.94-1.26) for total study cohort, 1.08 (95% CI 0.93-1.26) for acute sinusitis and 1.18 (95% CI 0.85-1.63) for chronic sinusitis.

Conclusion: Rhinosinusitis was associated with the risk of AF. Sinusitis patients with DM had a higher risk than patients without DM. The use of metformin might reduce the risk of AF in DM patients. Further clinical investigation is warranted.


H. Liu: None. Y. Fang: None. T. Lee: None. J. Liu: None.

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