Skip header and navigation

Refine By

   MORE

9 records – page 1 of 1.

Cyclooxygenase-2 inhibitors and cardiovascular risk in a nation-wide cohort study after the withdrawal of rofecoxib.

https://arctichealth.org/en/permalink/ahliterature129428
Source
Eur Heart J. 2012 Aug;33(15):1928-33
Publication Type
Article
Date
Aug-2012
Author
Magnus Bäck
Li Yin
Erik Ingelsson
Author Affiliation
Department of Cardiology, Karolinska University Hospital, L8:03, SE-171 76 Stockholm, Sweden. magnus.back@ki.se
Source
Eur Heart J. 2012 Aug;33(15):1928-33
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Atrial Fibrillation - chemically induced - mortality
Cardiovascular Diseases - chemically induced - mortality
Cyclooxygenase 2 Inhibitors - adverse effects
Epidemiologic Methods
Female
Heart Failure - chemically induced - mortality
Humans
Lactones - adverse effects
Male
Middle Aged
Myocardial Infarction - chemically induced - mortality
Prognosis
Pyrazoles - adverse effects
Safety-Based Drug Withdrawals
Stroke - chemically induced - mortality
Sulfonamides - adverse effects
Sulfones - adverse effects
Sweden - epidemiology
Abstract
The use of selective cyclooxygenase (COX)-2 inhibitors (coxibs) has been associated with an increased cardiovascular risk. The aim of the present study was to evaluate the association of coxib use and future risk of cardiovascular events in a population-based cohort followed after the warnings concerning the cardiovascular safety of this class of drugs were issued.
A nation-wide, population-based cohort of 7 million subjects, integrating data from the Prescribed Drug, Patient, Cause of Death, Income, Educational and Emigration Registers, was followed from 1 July 2005 to 31 December 2008. Analyses were performed for different cardiovascular outcomes in the whole population after exclusion of individuals with prior cardiovascular diagnosis (incident primary cardiovascular events; sample size, n = 6 991 645). Cox proportional hazard ratios (HRs) revealed no significant association of coxib use with risk for myocardial infarction, ischaemic stroke, or heart failure. In contrast to these findings, coxib use was associated with an increased risk for a first episode of atrial fibrillation [HR 1.16; 95% confidence interval (CI) 1.05-1.29]. A post hoc analysis for different coxibs revealed a significant association with incident atrial fibrillation for etoricoxib (HR 1.35; 95% CI 1.19-1.54) but not for celecoxib (HR 0.94; 95% CI 0.79-1.11).
Whereas safety measures appear to have limited serious cardiovascular consequences of COX-2 inhibitors, the risk of developing atrial fibrillation may have been overlooked and may necessitate consideration and precautions.
PubMed ID
22108833 View in PubMed
Less detail

Intravenous bisphosphonate therapy and atrial fibrillation/flutter risk in cancer patients: a nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature131771
Source
Br J Cancer. 2011 Sep 27;105(7):881-3
Publication Type
Article
Date
Sep-27-2011
Author
R. Erichsen
C F Christiansen
T. Frøslev
J. Jacobsen
H T Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200 Aarhus N, Denmark. re@dce.au.dk
Source
Br J Cancer. 2011 Sep 27;105(7):881-3
Date
Sep-27-2011
Language
English
Publication Type
Article
Keywords
Aged
Atrial Fibrillation - chemically induced
Atrial Flutter - chemically induced
Bone Density Conservation Agents - adverse effects
Case-Control Studies
Cohort Studies
Denmark - epidemiology
Diphosphonates - adverse effects
Female
Follow-Up Studies
Humans
Injections, Intravenous
Male
Neoplasms - drug therapy - epidemiology
Survival Rate
Treatment Outcome
Abstract
There is conflicting evidence regarding bisphosphonates and atrial fibrillation (AF) risk in osteoporosis patients. However, bisphosphonates are used in much higher doses in treatment of bone metastasis and hypercalcemia, but little is known about the AF risk in cancer patients.
We conducted a nationwide population-based cohort study using Danish databases. All cancer patients exposed to intravenous bisphosphonates during 2000-2008 were matched with two non-exposed cancer patients by cancer type, distant metastasis presence at diagnosis, age, and gender. We used Cox proportional hazard regression to estimate hazards ratios (HRs) of AF/flutter adjusting for important confounding factors.
Of the 3981 cancer patients exposed to intravenous bisphosponates, 128 (3.2%) developed AF/flutter. This condition occurred in 192 (2.4%) of the 7906 non-exposed cancer patients, corresponding to an adjusted HR of 1.7 (95% CI: 1.2-2.4).
Intravenous bisphosphonates may increase AF/flutter risk in cancer patients.
Notes
Cites: BMJ. 2008 Apr 12;336(7648):813-618334527
Cites: N Engl J Med. 2007 Nov 1;357(18):1799-80917878149
Cites: Clin Cancer Res. 2008 Oct 15;14(20):6387-9518927277
Cites: PLoS One. 2009;4(3):e472019266096
Cites: Am J Cardiol. 2009 Mar 15;103(6):824-819268739
Cites: Drug Saf. 2009;32(3):219-2819338379
Cites: J Intern Med. 2009 May;265(5):581-9219141097
Cites: BMC Musculoskelet Disord. 2009;10:11319772579
Cites: Arch Intern Med. 2009 Oct 12;169(18):1677-8319822824
Cites: Menopause. 2010 Jan-Feb;17(1):57-6319680161
Cites: Calcif Tissue Int. 2010 May;86(5):335-4220309678
Cites: Arthritis Res Ther. 2010;12(1):R3020170505
Cites: Int J Cardiol. 2010 Jul 23;142(3):213-720051297
Cites: J Clin Oncol. 2010 Nov 20;28(33):4898-90520940190
Cites: Am J Cardiovasc Drugs. 2010;10(6):359-6721090829
Cites: Support Care Cancer. 2011 Mar;19(3):425-3020358384
Cites: BMJ. 2003 Jul 12;327(7406):89-9512855529
Cites: Arch Intern Med. 2004 Oct 11;164(18):1993-815477433
Cites: Dan Med Bull. 1997 Nov;44(5):535-99408738
Cites: Dan Med Bull. 1999 Jun;46(3):263-810421985
Cites: Hepatology. 2006 Nov;44(5):1075-8217058242
Cites: Dan Med Bull. 2006 Nov;53(4):441-917150149
Cites: N Engl J Med. 2007 May 3;356(18):1809-2217476007
Cites: N Engl J Med. 2007 Aug 16;357(7):712-3; author reply 714-517703529
Cites: Arch Intern Med. 2008 Apr 28;168(8):826-3118443257
PubMed ID
21878939 View in PubMed
Less detail

Non-steroidal anti-inflammatory drug use and risk of atrial fibrillation or flutter: population based case-control study.

https://arctichealth.org/en/permalink/ahliterature133215
Source
BMJ. 2011;343:d3450
Publication Type
Article
Date
2011
Author
Morten Schmidt
Christian F Christiansen
Frank Mehnert
Kenneth J Rothman
Henrik Toft Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, 8200 Aarhus N, Denmark.
Source
BMJ. 2011;343:d3450
Date
2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal - adverse effects
Atrial Fibrillation - chemically induced - epidemiology
Atrial Flutter - chemically induced - epidemiology
Case-Control Studies
Child
Child, Preschool
Cyclooxygenase 2 Inhibitors - adverse effects
Denmark - epidemiology
Female
Humans
Infant
Male
Middle Aged
Prospective Studies
Registries
Risk factors
Young Adult
Abstract
To examine the risk of atrial fibrillation or flutter associated with use of non-selective non-steroidal anti-inflammatory drugs (NSAIDs) or selective cyclo-oxygenase (COX) 2 inhibitors.
Population based case-control study using data from medical databases.
Northern Denmark (population 1.7 million).
32 602 patients with a first inpatient or outpatient hospital diagnosis of atrial fibrillation or flutter between 1999 and 2008; 325 918 age matched and sex matched controls based on risk-set sampling.
Exposure to NSAID use at the time of admission (current use) or before (recent use). Current use was further classified as new use (first ever prescription redemption within 60 days before diagnosis date) or long term use. We used conditional logistic regression to compute odds ratios as unbiased estimates of the incidence rate ratios.
2925 cases (9%) and 21 871 controls (7%) were current users of either non-selective NSAIDs or COX 2 inhibitors. Compared with no use, the incidence rate ratio associating current drug use with atrial fibrillation or flutter was 1.33 (95% confidence interval 1.26 to 1.41) for non-selective NSAIDs and 1.50 (1.42 to 1.59) for COX 2 inhibitors. Adjustments for age, sex, and risk factors for atrial fibrillation or flutter reduced the incidence rate ratio to 1.17 (1.10 to 1.24) for non-selective NSAIDs and 1.27 (1.20 to 1.34) for COX 2 inhibitors. Among new users, the adjusted incidence rate ratio was 1.46 (1.33 to 1.62) for non-selective NSAIDs and 1.71 (1.56 to 1.88) for COX 2 inhibitors. Results for individual NSAIDs were similar.
Use of non-aspirin NSAIDs was associated with an increased risk of atrial fibrillation or flutter. Compared with non-users, the association was strongest for new users, with a 40-70% increase in relative risk (lowest for non-selective NSAIDs and highest for COX 2 inhibitors). Our study thus adds evidence that atrial fibrillation or flutter needs to be added to the cardiovascular risks to be considered when prescribing NSAIDs.
Notes
Comment In: BMJ. 2011;343:d249521727166
PubMed ID
21727167 View in PubMed
Less detail

NSAIDs, corticosteroids and atrial fibrillation?

https://arctichealth.org/en/permalink/ahliterature126058
Source
Prescrire Int. 2012 Mar;21(125):69-70
Publication Type
Article
Date
Mar-2012
Source
Prescrire Int. 2012 Mar;21(125):69-70
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adrenal Cortex Hormones - adverse effects
Anti-Inflammatory Agents - adverse effects
Anti-Inflammatory Agents, Non-Steroidal - adverse effects
Atrial Fibrillation - chemically induced - epidemiology - physiopathology
Case-Control Studies
Chronic Disease
Databases, Factual
Denmark - epidemiology
Dose-Response Relationship, Drug
Great Britain - epidemiology
Humans
Abstract
Evidence that a number of drugs can cause atrial fibrillation has been accumulating since the 2000s. A case-control analysis of a UK general medicine database showed statistically significant increases in the risk of chronic atrial fibrillation in patients taking NSAIDs, after as little as one month of treatment. When NSAID treatment lasted more than 30 days, the incidence was 9.4%, versus 4.7% in the control group, corresponding to a relative risk (RR) of 1.57 (95% confidence interval (95% CI): 1.15 to 2.15). Similar results were found in patients with no history of heart failure. A Danish case-control study yielded similar results. In the UK case-control study, a statistically significant increase in the risk of chronic atrial fibrillation was found in patients taking corticosteroids (5% versus 1.4% in the control group, RR=2.5, 95% CI: 1.6 to 4). The risk increased with the dose. Another Danish case-control study showed that hospitalisation for atrial fibrillation or flutter was twice as frequent among patients exposed to corticosteroids. In contrast, trials in which corticosteroids were given shortly after cardiac surgery, a highly specific setting, showed a decreased risk of atrial fibrillation. In practice, the risk of atrial fibrillation should be taken into account before deciding whether or not to prescribe a corticosteroid or an NSAID, especially to a patient with known risk factors for atrial fibrillation. The heart rate of treated patients should be closely monitored.
PubMed ID
22428188 View in PubMed
Less detail

Oral bisphosphonates and risk of ischemic stroke: a case-control study.

https://arctichealth.org/en/permalink/ahliterature140083
Source
Osteoporos Int. 2011 Jun;22(6):1773-9
Publication Type
Article
Date
Jun-2011
Author
S. Christensen
F. Mehnert
R D Chapurlat
J A Baron
H T Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Alle 43-45, 8240 Aarhus N, Denmark. sc@dce.au.dk
Source
Osteoporos Int. 2011 Jun;22(6):1773-9
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Administration, Oral
Aged
Aged, 80 and over
Atrial Fibrillation - chemically induced - epidemiology
Bone Density Conservation Agents - administration & dosage - adverse effects
Brain Ischemia - chemically induced - epidemiology
Comorbidity
Denmark - epidemiology
Diphosphonates - administration & dosage - adverse effects
Drug Prescriptions - statistics & numerical data
Drug Utilization - statistics & numerical data
Epidemiologic Methods
Female
Humans
Middle Aged
Stroke - chemically induced - epidemiology
Abstract
Bisphosphonates have been associated with an increased risk of atrial fibrillation and may thus be associated with an increased risk of ischemic stroke. This would have substantial clinical and public health implications. We found no evidence of an association between bisphosphonate use and risk of ischemic stroke.
Bisphosphonates have been associated with an increased risk of atrial fibrillation in some studies and may be associated with an increased risk of ischemic stroke. However, data regarding these possibilities are limited.
We conducted a population-based case-control study of 6,257 female cases of ischemic stroke and 31,285 age- and gender-matched population controls. Data on bisphosphonate use, other medication use, comorbidity, and ischemic stroke were obtained from medical databases. Current bisphosphonate use was defined as at least one redeemed prescription within 90 days before diagnosis/index date. We estimated the odds ratio (OR) of ischemic stroke among users and nonusers of bisphosphonates using conditional logistic regression, controlling for potential confounding factors.
One hundred eighty-two (2.9%) cases and 901 (2.9%) controls were current users of bisphosphonates. Etidronate and alendronate were prescribed with similar frequency among cases and controls. The adjusted OR of ischemic stroke for bisphosphonate users compared with nonusers was 0.97 (95% confidence interval [CI], 0.82-1.15). New and continuing bisphosphonate users had adjusted ORs for ischemic stroke of 1.16 (95% CI, 0.69-1.96) and 0.97 (95% CI, 0.81-1.16), respectively. Excluding patients with known atrial fibrillation/flutter yielded an OR of 1.00 (95% CI, 0.85-1.19). The OR for ischemic stroke was 0.59 (95% CI, 0.32-1.09) among patients with a history of previous hospitalization for cardiovascular disease and 1.07 (95% CI, 0.88-1.18) among those without (P
PubMed ID
20945149 View in PubMed
Less detail

Risk of atrial fibrillation associated with use of bisphosphonates and other drugs against osteoporosis: a cohort study.

https://arctichealth.org/en/permalink/ahliterature97614
Source
Calcif Tissue Int. 2010 May;86(5):335-42
Publication Type
Article
Date
May-2010
Author
Peter Vestergaard
Kristoffer Schwartz
Else Marie Pinholt
Lars Rejnmark
Leif Mosekilde
Author Affiliation
Department of Endocrinology and Metabolism C, Aarhus University Hospital, Tage Hansens Gade 2, 8000 Arhus C, Denmark. p-vest@post4.tele.dk
Source
Calcif Tissue Int. 2010 May;86(5):335-42
Date
May-2010
Language
English
Publication Type
Article
Keywords
Aged
Alendronate - administration & dosage
Atrial Fibrillation - chemically induced - epidemiology - physiopathology
Atrial Flutter - chemically induced - epidemiology - physiopathology
Bone Density Conservation Agents - administration & dosage
Cohort Studies
Comorbidity
Confounding Factors (Epidemiology)
Denmark - epidemiology
Diphosphonates - administration & dosage
Etidronic Acid - administration & dosage
Female
Humans
Male
Middle Aged
Osteoporosis, Postmenopausal - drug therapy - physiopathology
Pulmonary Disease, Chronic Obstructive - epidemiology
Raloxifene - administration & dosage
Retrospective Studies
Risk factors
Abstract
We studied the association between bisphosphonate use and risk of atrial fibrillation or flutter and the effect of confounders such as heart and lung disease in a nationwide retrospective cohort from Denmark. All users of bisphosphonates and other drugs against osteoporosis between 1996 and 2006 (n = 103,562) were the exposed group and three age- and gender-matched controls from the general population (n = 310,683) were the nonexposed group. The main outcome measure was atrial fibrillation or atrial flutter. Before initiation of treatment against osteoporosis, no excess of atrial fibrillation or flutter was present for any drug except for etidronate (OR = 1.22, 95% CI 1.15-1.29). After initiation of treatment, raloxifene was not associated with any excess risk of atrial fibrillation (OR = 0.98, 95% CI 0.72-1.33). Etidronate (HR = 1.08, 95% CI 1.02-1.14) and alendronate (HR = 1.09, 95% CI 1.00-1.20) were associated with an excess risk of atrial fibrillation after treatment start if statistical adjustments were made for cardiovascular disease. However, this association disappeared upon statistical adjustment for chronic obstructive pulmonary disease (COPD) (etidronate HR = 1.04, 95% CI 0.98-1.10; alendronate HR = 1.05, 95% CI 0.96-1.15). In patients using etidronate (12.5% vs. 3.8%) and alendronate (11.4% vs. 4.6%) major differences were present in prevalence of COPD at start of treatment compared to matched controls. In conclusion, oral bisphosphonates do not seem to be associated with an excess risk of atrial fibrillation. Any excess risk seen in prior studies may be due to confounding from COPD.
PubMed ID
20309678 View in PubMed
Less detail

Risk of intracranial hemorrhage (RICH) in users of oral antithrombotic drugs: Nationwide pharmacoepidemiological study.

https://arctichealth.org/en/permalink/ahliterature298038
Source
PLoS One. 2018; 13(8):e0202575
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Date
2018
Author
Sasha Gulati
Ole Solheim
Sven M Carlsen
Lise R Øie
Heidi Jensberg
Agnete M Gulati
Mattis A Madsbu
Charalampis Giannadakis
Asgeir S Jakola
Øyvind Salvesen
Author Affiliation
Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.
Source
PLoS One. 2018; 13(8):e0202575
Date
2018
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Aged
Anticoagulants - administration & dosage - adverse effects
Aspirin - administration & dosage - adverse effects
Atrial Fibrillation - chemically induced - pathology
Clopidogrel - administration & dosage - adverse effects
Dabigatran - administration & dosage - adverse effects
Female
Fibrinolytic Agents - administration & dosage - adverse effects
Humans
Intracranial Hemorrhages - chemically induced - epidemiology - pathology
Male
Middle Aged
Norway - epidemiology
Pharmacoepidemiology
Risk factors
Rivaroxaban - administration & dosage - adverse effects
Thrombosis - complications - drug therapy - epidemiology - pathology
Warfarin - administration & dosage - adverse effects
Abstract
The risks of intracranial haemorrhage (ICH) associated with antithrombotic drugs outside clinical trials are gaining increased attention. The aim of this nationwide study was to investigate the risk of ICH requiring hospital admission in users of antithrombotic drugs.
Data from the Norwegian Patient Registry and Norwegian Prescription Database were linked on an individual level. The primary outcome was incidence rates of ICH associated with use of antithrombotic drugs. Secondary endpoints were risk of ICH and fatal outcome following ICH assessed by Cox models. Among 3,131,270 individuals =18 years old observed from 2008 through 2014, there were 729,818 users of antithrombotic medications and 22,111 ICH hospitalizations. Annual crude ICH rates per 100 person-years were 0.076 (95% CI, 0.075-0.077) in non-users and 0.30 (95% CI, 0.30-0.31) in users of antithrombotic medication, with the highest age and sex adjusted rates observed for aspirin-dipyridamole plus clopidogrel (0.44; 95% CI, 0.19-0.69), rivaroxaban plus aspirin (0.36; 95% CI, 0.16-0.56), warfarin plus aspirin (0.34; 95% CI, 0.26-0.43), and warfarin plus aspirin and clopidogrel (0.33; 95% CI, 0.073-0.60). With no antithrombotic medication as reference, the highest adjusted hazard ratios (HR) for ICH were observed for aspirin-dypiridamole plus clopidogrel (6.29; 95% CI 3.71-10.7), warfarin plus aspirin and clopidogrel (4.38; 95% CI 2.71-7.09), rivaroxaban plus aspirin (3.82; 95% CI, 2.46-5.95), and warfarin plus aspirin (3.40; 95% CI, 2.99-3.86). All antithrombotic medication regimens were associated with an increased risk of ICH, except dabigatran monotherapy (HR 1.20; 95% CI, 0.88-1.65) and dabigatran plus aspirin (HR 1.79; 95% CI, 0.96-3.34). Fatal outcome within 90 days was more common in users (2,603 of 8,055) than non-users (3,228 of 14,056) of antithrombotic medication (32.3% vs 23.0%, p
PubMed ID
30138389 View in PubMed
Less detail

Use of bisphosphonates among women and risk of atrial fibrillation and flutter: population based case-control study.

https://arctichealth.org/en/permalink/ahliterature87052
Source
BMJ. 2008 Apr 12;336(7648):813-6
Publication Type
Article
Date
Apr-12-2008
Author
Sørensen Henrik Toft
Christensen Steffen
Mehnert Frank
Pedersen Lars
Chapurlat Roland D
Cummings Steven R
Baron John A
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus C, Denmark. hts@dce.au.dk
Source
BMJ. 2008 Apr 12;336(7648):813-6
Date
Apr-12-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Atrial Fibrillation - chemically induced
Atrial Flutter - drug therapy
Bone Density Conservation Agents - administration & dosage - adverse effects
Case-Control Studies
Diphosphonates - administration & dosage - adverse effects
Female
Fractures, Bone
Humans
Middle Aged
Osteoporosis - drug therapy
Risk factors
Abstract
OBJECTIVE: To assess the association between atrial fibrillation and flutter and use of bisphosphonates for osteoporosis among women. DESIGN: Population based case-control study, using medical databases from Denmark. SETTING: Northern Denmark. PARTICIPANTS: 13 586 patients with atrial fibrillation and flutter and 68 054 population controls, all with complete hospital and prescription history. MAIN OUTCOME MEASURE: Adjusted relative risk of atrial fibrillation and flutter. RESULTS: 435 cases (3.2%) and 1958 population controls (2.9%) were current users of bisphosphonates for osteoporosis. Etidronate and alendronate were used with almost the same frequency among cases and controls. The adjusted relative risk of current use of bisphosphonates compared with non-use was 0.95 (95% confidence interval 0.84 to 1.07). New users had a relative risk of 0.75 (95% confidence interval 0.49 to 1.16), broadly similar to the estimate for continuing users (relative risk 0.96, 95% confidence interval 0.85 to 1.09). The relative risk estimates were independent of number of prescriptions and the position of the atrial fibrillation and flutter diagnosis in the discharge record, and were similar for inpatients and outpatients. CONCLUSION: No evidence was found that use of bisphosphonates increases the risk of atrial fibrillation and flutter.
Notes
Comment In: BMJ. 2008 Apr 12;336(7648):784-518334526
PubMed ID
18334527 View in PubMed
Less detail

Use of Scandinavian moist smokeless tobacco (snus) and the risk of atrial fibrillation.

https://arctichealth.org/en/permalink/ahliterature263420
Source
Epidemiology. 2014 Nov;25(6):872-6
Publication Type
Article
Date
Nov-2014
Author
Maria-Pia Hergens
Rosaria Galanti
Jenny Hansson
Peeter Fredlund
Anders Ahlbom
Lars Alfredsson
Rino Bellocco
Marie Eriksson
Eleonor I Fransson
Johan Hallqvist
Jan-Håkan Jansson
Anders Knutsson
Nancy Pedersen
Ylva Trolle Lagerros
Per-Olof Ostergren
Cecilia Magnusson
Source
Epidemiology. 2014 Nov;25(6):872-6
Date
Nov-2014
Language
English
Publication Type
Article
Keywords
Adult
Atrial Fibrillation - chemically induced - epidemiology
Humans
Male
Prevalence
Prospective Studies
Registries
Risk
Risk factors
Sweden - epidemiology
Tobacco, Smokeless - toxicity
Abstract
Snus is a smokeless tobacco product, widely used among Swedish men and increasingly so elsewhere. There is debate as to whether snus is an acceptable "harm-reduction" tobacco product. Since snus use delivers a dose of nicotine equivalent to cigarettes, and has been implicated in cardiac arrhythmia because of associations with sudden cardiovascular death, a relation with atrial fibrillation is plausible and important to investigate.
To assess the relation between use of snus and risk of atrial fibrillation, we carried out a pooled analysis of 7 prospective Swedish cohort studies. In total, 274,882 men, recruited between 1978 and 2004, were followed via the National Patient Register for atrial fibrillation. Primary analyses were restricted to 127,907 never-smokers. Relative risks were estimated using Cox proportional hazard regression.
The prevalence of snus use was 25% among never-smokers. During follow-up, 3,069 cases of atrial fibrillation were identified. The pooled relative risk of atrial fibrillation was 1.07 (95% confidence interval = 0.97-1.19) in current snus users, compared with nonusers.
Findings from this large national pooling project indicate that snus use is unlikely to confer any important increase in risk of atrial fibrillation.
PubMed ID
25166877 View in PubMed
Less detail

9 records – page 1 of 1.