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We applaud van der Hooft et al¹ in their study, demonstrating that the risk of new-onset atrial fibrillation (AF) was significantly higher for persons who received a corticosteroid prescription within 1 month before the index date than for those without (odds ratio [OR], 3.75; 95% confidence interval [CI], 2.38-5.87). The fact that only high-dose corticosteroid use was associated with an increased risk (OR, 6.07; 95% CI, 3.90-9.42), whereas low to intermediate dose corticosteroid use was not (OR, 1.42; 95% CI, 0.72-2.82), and that the association of AF with high-dose corticosteroid use was largely independent of the indication for corticosteroid therapy suggests that one possible explanation could be the sudden derangement in glucose metabolism resulting in fluctuating levels of glycemic control,² which occurs with high-dose corticosteroid therapy. Indeed, previous reports have demonstrated that high glucose levels had a positive significant association with the risk of AF.^3-4 Nearly a decade ago, Psaty . . . [Full Text of this Article]

AUTHOR INFORMATION
George I. Varughese, MRCP; John H. B. Scarpello, MD, FRCP

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