Increased risk of atrial fibrillation and flutter in patients with Cushing's syndrome: a population-based matched cohort study.
A, P., Y, R., S, K., T, S., C, G., K, I., N, A., M, F., & A, A. (2026). Increased risk of atrial fibrillation and flutter in patients with Cushing's syndrome: a population-based matched cohort study.. European journal of endocrinology. https://doi.org/10.1093/ejendo/lvag094
A P, Y R, S K, T S, C G, K I, et al. Increased risk of atrial fibrillation and flutter in patients with Cushing's syndrome: a population-based matched cohort study.. European journal of endocrinology. 2026; doi: 10.1093/ejendo/lvag094
A P, Y R, S K, et al. Increased risk of atrial fibrillation and flutter in patients with Cushing's syndrome: a population-based matched cohort study.[J]. European journal of endocrinology. 2026. DOI: 10.1093/ejendo/lvag094.
@article{a2026,
author = {Polansky A and Rudman Y and Kushnir S and Shochat T and Gurevitz C and Isand K and Agrawal N and Fleseriu M and Akirov A},
title = {Increased risk of atrial fibrillation and flutter in patients with Cushing's syndrome: a population-based matched cohort study.},
journal = {European journal of endocrinology},
year = {2026},
doi = {10.1093/ejendo/lvag094},
note = {PMID: 42200260},
}
TY - JOUR AU - Polansky A AU - Rudman Y AU - Kushnir S AU - Shochat T AU - Gurevitz C AU - Isand K AU - Agrawal N AU - Fleseriu M AU - Akirov A TI - Increased risk of atrial fibrillation and flutter in patients with Cushing's syndrome: a population-based matched cohort study. T2 - European journal of endocrinology PY - 2026 DO - 10.1093/ejendo/lvag094 AN - PMID:42200260 ER -
BACKGROUND: Patients with Cushing's syndrome (CS) have a high prevalence of cardiovascular disease, and other recognized risk factors for atrial fibrillation/flutter (AF/AFL); however, the prevalence of AF/AFL has not been well characterized in this population. METHODS: We conducted a retrospective matched-cohort study using the Clalit Health Services database, including patients with CS and 1:5 matched controls. We assessed the risk of new-onset AF/AFL overall and according to disease etiology and remission status. Pre-existing AF/AFL was defined as >30 days before CS, and new-onset as within 30 days or thereafter. RESULTS: The cohort included 609 patients with CS and 3018 controls. Pre-existing AF/AFL was more common among patients with CS than controls (3.6% vs. 2.1%; OR 1.70, 95% CI 1.04-2.78). During a mean follow-up of 15 years, patients with CS had a significantly higher risk of developing new-onset AF/AFL compared with controls (HR 1.55, 95% CI 1.19-2.03). This increased risk was observed in both Cushing's disease (CD) (HR 1.53, 95% CI 1.01-2.32) and adrenal CS (HR 1.70, 95% CI 1.06-2.74). AF/AFL risk did not significantly differ according to remission status, although a trend toward lower risk was observed. Multivariate analysis identified older age at diagnosis, male sex, hypertension, vascular disease, and higher BMI as predictors for new-onset AF/AFL. 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.