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Editor's Correspondence
September 18, 2006

Corticosteroids and Atrial Fibrillation: Risks or Benefits?

Arch Intern Med. 2006;166(16):1785-1786. doi:10.1001/archinte.166.16.1785-b

We read with great interest the recent case-control study by van der Hooft et al,1 which showed that high-dose corticosteroid therapy increased the risk of developing AF in a population-based cohort, and they also presented some potential mechanisms that may contribute to this association. However, Dernellis and Panaretou2 demonstrated that low-dose glucocorticoid therapy following successful cardioversion of persistent AF could prevent recurrent AF, and this effect correlated with a significant reduction of C-reactive protein levels. Furthermore, another prospective randomized study3 also showed that short-term corticosteroid administration in patients undergoing coronary artery bypass grafting significantly reduced postoperative AF. The protective effects of corticosteroid therapy on AF are possibly explained by anti-inflammatory mechanisms.4,5

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