Abstract

Introduction: Autonomic nervous system (ANS) dysfunction contributes to several non-motor symptoms of Parkinson's disease (PD). In addition, ANS plays a role in the genesis and maintenance of atrial fibrillation (AF). This study investigated the temporal association between PD and AF. Methods: Data were obtained from the National Health Insurance Research Database of Taiwan. In total, 15,375 patients with newly diagnosed PD were matched with four controls each based on the propensity score. This study was bidirectional. A case-control study for the odds ratio (OR) of AF before PD and within 2 years of PD diagnosis was evaluated through conditional logistic regression. Furthermore, a cohort study on the subdistribution hazard ratio (SHR) for new-onset AF 2 years after PD diagnosis was evaluated using competing risk analysis. Results: In the case-control study, PD was found to be significantly comorbid with AF (adjusted OR: 1.15, 95% confidence interval [CI]: 1.04–1.28). Subgroup analysis demonstrated that this association consistently presented in the absence of confounding factors of AF. In the cohort study, people with PD were found to have a lower risk of AF (adjusted SHR: 0.92, 95% CI: 0.86–0.98). However, a consistent association was not observed between the confounding factors of AF and PD during the subgroup analysis. Conclusions: This study demonstrated that the premotor and early stages of PD were comorbid with AF, whereas the risk of AF was lower in the later stages. Thus, AF might be a premotor predictive biomarker and comorbidity of early PD.

Original languageEnglish
Article number22
JournalFrontiers in Neurology
Volume10
Issue numberFEB
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Atrial Fibrillation
Parkinson Disease
Population
Autonomic Nervous System
Case-Control Studies
Cohort Studies
Odds Ratio
Confidence Intervals
Propensity Score
National Health Programs
Taiwan
Comorbidity
Biomarkers
Logistic Models
Maintenance
Databases

Keywords

  • Atrial fibrillation
  • Autonomic nerve system
  • Biomarker
  • Parkinson's disease
  • Population-based study

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Association between Parkinson's disease and atrial fibrillation : A population-based study. / Hong, Chien Tai; Chan, Lung; Wu, Dean; Chen, Wan Ting; Chien, Li Nien.

In: Frontiers in Neurology, Vol. 10, No. FEB, 22, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Introduction: Autonomic nervous system (ANS) dysfunction contributes to several non-motor symptoms of Parkinson's disease (PD). In addition, ANS plays a role in the genesis and maintenance of atrial fibrillation (AF). This study investigated the temporal association between PD and AF. Methods: Data were obtained from the National Health Insurance Research Database of Taiwan. In total, 15,375 patients with newly diagnosed PD were matched with four controls each based on the propensity score. This study was bidirectional. A case-control study for the odds ratio (OR) of AF before PD and within 2 years of PD diagnosis was evaluated through conditional logistic regression. Furthermore, a cohort study on the subdistribution hazard ratio (SHR) for new-onset AF 2 years after PD diagnosis was evaluated using competing risk analysis. Results: In the case-control study, PD was found to be significantly comorbid with AF (adjusted OR: 1.15, 95{\%} confidence interval [CI]: 1.04–1.28). Subgroup analysis demonstrated that this association consistently presented in the absence of confounding factors of AF. In the cohort study, people with PD were found to have a lower risk of AF (adjusted SHR: 0.92, 95{\%} CI: 0.86–0.98). However, a consistent association was not observed between the confounding factors of AF and PD during the subgroup analysis. Conclusions: This study demonstrated that the premotor and early stages of PD were comorbid with AF, whereas the risk of AF was lower in the later stages. Thus, AF might be a premotor predictive biomarker and comorbidity of early PD.",
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