ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1893

Increased Atrial Fibrillation Risk in Rheumatoid Arthritis: Greater in Seropositive Than Seronegative Patients

Hyungjin Kim1, Seonyoung Kang2, Kyungdo Han3, Jinhyung Jung4, Seulkee Lee5, Hoon-Suk Cha5, Jaejoon Lee6, Seonghye Kim5 and Se Yun Kim7, 1Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, 2Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Republic of Korea, 3Soongsil University, Seoul, Republic of Korea, 4Sungkyunkwan University School of Medicine, Suwon, Republic of Korea, 5Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, 6Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, 7Sungkyunkwan University, Seoul, Republic of Korea

Meeting: ACR Convergence 2025

Keywords: ,

Session Information

Date: Tuesday, October 28, 2025

Title: (1877–1913) Epidemiology & Public Health Poster III

Session Type: Poster Session C

Session Time: 10:30AM-12:30PM

Background/Purpose: The association between rheumatoid arthritis (RA) and cardiovascular disease (CVD) is well-established, with systemic inflammation as a potential mechanism. Although atrial fibrillation (AF) is the most common arrhythmia, the link between RA and AF has received less attention compared to other CVD traits like myocardial infarction and stroke.This study aimed to examine the association between RA and incident AF in Republic of Korea, considering serostatus (seropositive RA [SPRA], seronegative RA [SNRA]) and the use of biologic or targeted synthetic DMARDs (b/tsDMARDs).

Methods: This retrospective cohort study used the National Health Insurance Service database to include participants (aged ≥40 years) who were first diagnosed with RA between 2010 and 2017, had no previous AF, and who had a health checkup within 2 years before the index date (to collect covariate information). Matched non-RA controls were selected at a 1:3 ratio by age, sex, and index date. Participants were followed from 1 year after the index date until December 31, 2020, to mitigate surveillance bias.

Results: Totals of 48,885 RA patients (34,699 SPRA, 14,186 SNRA) and 146,655 matched controls were included. Patients with RA had a significantly higher risk of AF than did controls (adjusted hazard ratio [aHR] 1.55, 95% confidence interval [95% CI] 1.46-1.65). Both patients with SPRA (aHR 1.63, 95% CI 1.52-1.74) and SNRA (aHR 1.37, 95% CI 1.23-1.53) had a higher AF risk than did those without RA. Patients with SPRA had a higher risk compared to those with SNRA (aHR 1.19, 95% CI 1.02-6.34). The use of bDMARDs was associated with a slightly higher risk of AF, while tsDMARD use led to risk reduction but, non-statistical significant.

Conclusion: This study shows that both patients with SPRA and SNRA are at a significantly greater risk for AF compared to those without RA, with SPRA patients at the highest risk. The use of b/tsDMARDs might be associated with RA-related AF, but further studies are warranted to confirm this association and understand the underlying mechanisms.

Disclosures: H. Kim: None; S. Kang: None; K. Han: None; J. Jung: None; S. Lee: None; H. Cha: None; J. Lee: Samsung Bioepis, 5; S. Kim: None; S. Kim: None.

To cite this abstract in AMA style:

Kim H, Kang S, Han K, Jung J, Lee S, Cha H, Lee J, Kim S, Kim S. Increased Atrial Fibrillation Risk in Rheumatoid Arthritis: Greater in Seropositive Than Seronegative Patients [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/increased-atrial-fibrillation-risk-in-rheumatoid-arthritis-greater-in-seropositive-than-seronegative-patients/. Accessed .

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