Po-01-193 smoking cessation reduces the risk of incident atrial fibrillation

Active smoking is now an established risk factor atrial fibrillation (AF). However, whether smoking cessation reduces the risk of AF remains unknown. To determine whether those who quit smoking experience a lower risk of AF compared to those who continue to smoke. We utilized the UK Biobank, a prospective cohort study with serial assessments of lifestyle and medical diagnoses. The analyses were constrained to those who smoked at baseline, did not have prevalent AF, and that completed at least one follow-up smoking survey. Smoking cessation was identified from follow-up smoking surveys. Incident AF was ascertained using inpatient and outpatient healthcare coding diagnoses. Multivariable Cox proportional hazards models were used to assess the association between smoking cessation and incident AF. Among 3718 subjects meeting inclusion and exclusion criteria, the median follow-up time was 1059 days (IQR 457-2504 days). Median age was 54 years old (IQR 47-60 years), 1587 (43%) were female, and 145 (4%) were non-white. During follow-up, 1889 (51%) quit smoking. Among the 32 (0.86%) of those that experienced new AF after their follow up visit, 9 (28%) occurred in those that quit smoking and 23 (72%) among ongoing smokers (Figure). After adjusting for age, sex, ethnicity, body mass index, hypertension, hyperlipidemia, diabetes, coronary artery disease, valvular heart disease, congestive heart failure, chronic kidney disease, peripheral artery disease, cancer, alcohol use, smoking cessation was associated with a 55% lower risk of incident AF (HR 0.45, 95% CI 0.21 to 0.98, p = 0.044). Among smokers, those who quit experienced a substantially lower risk of developing AF. These results suggest that the heightened risk of AF among smokers is not immutable, but rather that smoking cessation may be a useful strategy to prevent AF.