Abstract 4123653: Association of Inflammatory Bowel Disease with the Risk of Atrial Fibrillation: A Meta-Analysis

Background: Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is a prevalent condition associated with chronic noninfectious inflammation of the gastrointestinal tract. It has been hypothesized that chronic inflammation can predispose patients to atrial fibrillation (AF), with proposed mechanisms being structural remodeling of atrial tissue, autonomic dysfunction, and oxidative stress; however, no clear evidence exists to support this. Aims: Our meta-analysis aims to pool all existing data to determine if there is an increased risk of AF in patients with IBD, providing more robust evidence on the matter. Methods: A systematic literature search was conducted using major databases (PubMed, EMBASE, and SCOPUS) aimed at studies focusing on AF development in patients with IBD. Further subgroup analyses were performed for ulcerative colitis (UC) and crohn’s disease (CD). Risk ratios (RR) with their corresponding 95% confidence intervals (CI) were pooled using a random-effects model in the Review Manager Software. Statistical significance was set at p < 0.05. Results: Seven studies with 88,893,407 patients were included (1,002,719 and 87, 890, 688 patients in the IBD and non-IBD groups, respectively). IBD patients were at an increased risk of developing AF [RR: 1.52; 95% CI: 1.19-1.95; p=0.0009] compared to the non-IBD group. In subgroup analyses, patients with UC were at an increased risk of developing AF [RR: 1.29; 95% CI: 1.08-1.53; p=0.004], as were CD patients [RR: 1.30; 95% CI: 1.07-1.58; p=0.008] compared to the non-UC and non-CD groups, respectively (Figure 1). Conclusion: Patients with IBD are at nearly 1.5 times the risk of developing AF compared to the non-IBD population. Our meta-analysis was limited by heterogeneity among the studies, highlighting the importance of further large-scale prospective studies to establish more robust evidence and determine the real-world clinical significance of our findings. Furthermore, future research should explore the impact of confounding variables such as disease severity, medication usage, and lifestyle factors on the observed association between IBD and AF.