Increased risk of atrial fibrillation and flutter in patients with Cushing's syndrome: a population-based matched cohort study
Main finding · New-onset AF/AFLResult — go to the resultHazard ratio 1.55 95% CI 1.19–2.03Authors' conclusion
CS is associated with an increased risk of AF/AFL. This elevated risk is observed across both CD and adrenal CS and persists despite disease remission, underscoring the need for heightened awareness and close cardiovascular surveillance in this population. The increased risk of AF/AFL appears to be primarily driven by coexisting cardiovascular comorbidities rather than cortisol excess or other CS-specific features.
Study context
- Population
- Patients with Cushing's syndrome (CS) and 1:5 matched controls, Clalit Health Services databasematched cohort
- Participants
- 609 vs 3,018
- Exposure
- CS vs matched controls
- CSn = 609
- Controlsn = 3,018reference
- Outcome
- New-onset AF/AFL (within 30 days of CS or thereafter)
- Follow-up
- Mean 15 years
Methodological detailsmatched cohort, 1:5 matched controls, population-based
- Matched cohort
- 1:5 matched controls
- Population-based
Main finding
New-onset AF/AFL
Hazard ratio
1.55
95% CI 1.19–2.03
CSvs Controls
HR 1.55 (95% CI 1.19–2.03)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | CS | Controls | Estimate | |
|---|---|---|---|---|
| Pre-existing AF/AFL (>30 days before CS) | 3.6% | 2.1% | OR 1.70 (95% CI 1.04–2.78) | |
| New-onset AF/AFL by etiology: CDCDvs Controls | HR 1.53 (95% CI 1.01–2.32) | |||
| New-onset AF/AFL by etiology: adrenal CSAdrenal CSvs Controls | HR 1.70 (95% CI 1.06–2.74) | |||
| 0.20.5125Ratio (log scale) |
New-onset AF/AFL by remission status
- AF/AFL risk did not significantly differ by remission status; trend toward lower risk
Predictors of new-onset AF/AFL (multivariate analysis)
- Older age at diagnosis, male sex, hypertension, vascular disease and higher BMI predicted new-onset AF/AFL
Original publication
Increased risk of atrial fibrillation and flutter in patients with Cushing's syndrome: a population-based matched cohort study. Eur J Endocrinol. Published 26 May 2026. doi:10.
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