Abstract
BACKGROUND AND AIMS: Calcium plays a crucial role in cardiac electrophysiology, but the association between calcium supplement and the risk of incident arrhythmia remains unclear.
OBJECTIVE: To investigate the relationship between habitual calcium supplement and incident risk of cardiac arrhythmia.
METHODS: We conducted a prospective study of 480,972 participants from the UK Biobank. Habitual calcium supplement was treated as the main exposure. The primary outcome was the incidence of arrhythmias, including atrial fibrillation/flutter (AF/AFL), ventricular arrhythmia (VA), and bradyarrhythmia. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
RESULTS: After a median follow-up of 11.69 years, 46,609 incident arrhythmia cases were documented, including 36,406 AF/AFL, 5,370 VA, and 14,226 bradyarrhythmia. After multivariable adjustment, calcium supplement was associated with an increased risk of total arrhythmias (HR 1.11, 95% CI 1.05-1.19), AF/AFL (HR 1.20, 95% CI 1.12-1.28), VA (HR 1.14, 95% CI 1.07-1.21), and bradyarrhythmia (HR 1.18, 95% CI 1.11-1.26). Significant interactions were observed between calcium supplement and estimated glomerular filtration rate, diabetes, cardiovascular disease, and polygenic risk score for AF (all p for interaction < 0.05).
CONCLUSIONS: Calcium supplement was associated with an increased risk of incident arrhythmia. Careful evaluation of the potential arrhythmic risk is warranted when considering calcium supplement in individuals with clinical indications.