Yu-Sheng Lin1, Tao-Hsin Tung2, Jui Wang3, Yu-Fen Chen4, Tien-Hsing Chen5, Ming-Sheng Lin6, Ching-Chi Chi7, Mien-Cheng Chen8. 1. Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Centre for Evidence-Based Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. 2. Department of Medical Research and Education, Cheng Hsin General Hospital, Taipei, Taiwan; Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan. 3. Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. 4. Department of Health, Taipei City Government, Taipei, Taiwan; Institute of Health and Welfare Policy, National Yang Ming University, Taipei, Taiwan; Department of Nursing, Kang-Ning Junior College of Medical Care and Management, Taipei, Taiwan. 5. Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan. 6. Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Yulin, Taiwan. 7. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Centre for Evidence-Based Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Dermatology, Chang Gung Memorial Hospital, Chiayi, Taiwan. Electronic address: chingchi@cgmh.org.tw. 8. Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan. Electronic address: chenmien@ms76.hinet.net.
Abstract
BACKGROUND: Peripheral arterial disease (PAD) and atrial fibrillation (AF) share several comorbidities and contribute to similar cardiovascular (CV) outcomes. Only few studies have evaluated the correlation between PAD, AF, and their interaction effects on CV outcomes. METHODS: We included 597,164 adults from Taiwan's National Health Insurance Research Database to conduct a cohort study to assess whether PAD was an independent risk factor of AF and vice versa. We also examined if PAD and AF increased the incident stroke, heart failure hospitalization and CV death. RESULTS: People with PAD had a significant higher risk of incident AF than those without PAD [adjusted hazard ratio (HR): 1.29, 95% confidence interval (CI): 1.17-1.42]. Meanwhile, people with AF did not have an increased risk of incident PAD compared to those without AF (adjusted HR: 1.00, 95% CI: 0.89-1.11). Both AF and PAD increased the risk of stroke [adjusted HR being 1.29 (95% CI: 1.17-1.43) and 1.41 (95% CI: 1.35-1.47), respectively], heart failure hospitalization [adjusted HR being 1.96 (95% CI: 1.77-2.17) and 1.35 (95% CI: 1.28-1.42), respectively], and CV death [adjusted HR being 3.33 (95% CI: 2.58-4.30) and 2.08 (95% CI: 1.80-2.41), respectively]. However, we found no interaction effects of AF and PAD on these outcomes. CONCLUSIONS: PAD is an independent risk factor of incident AF but not vice versa. Both PAD and AF are independent risk factors for stroke, heart failure hospitalization, and CV death.
BACKGROUND:Peripheral arterial disease (PAD) and atrial fibrillation (AF) share several comorbidities and contribute to similar cardiovascular (CV) outcomes. Only few studies have evaluated the correlation between PAD, AF, and their interaction effects on CV outcomes. METHODS: We included 597,164 adults from Taiwan's National Health Insurance Research Database to conduct a cohort study to assess whether PAD was an independent risk factor of AF and vice versa. We also examined if PAD and AF increased the incident stroke, heart failure hospitalization and CV death. RESULTS:People with PAD had a significant higher risk of incident AF than those without PAD [adjusted hazard ratio (HR): 1.29, 95% confidence interval (CI): 1.17-1.42]. Meanwhile, people with AF did not have an increased risk of incident PAD compared to those without AF (adjusted HR: 1.00, 95% CI: 0.89-1.11). Both AF and PAD increased the risk of stroke [adjusted HR being 1.29 (95% CI: 1.17-1.43) and 1.41 (95% CI: 1.35-1.47), respectively], heart failure hospitalization [adjusted HR being 1.96 (95% CI: 1.77-2.17) and 1.35 (95% CI: 1.28-1.42), respectively], and CV death [adjusted HR being 3.33 (95% CI: 2.58-4.30) and 2.08 (95% CI: 1.80-2.41), respectively]. However, we found no interaction effects of AF and PAD on these outcomes. CONCLUSIONS: PAD is an independent risk factor of incident AF but not vice versa. Both PAD and AF are independent risk factors for stroke, heart failure hospitalization, and CV death.
Authors: Kamel Mohammedi; Mark Woodward; Yoichiro Hirakawa; Sophia Zoungas; Stephen Colagiuri; Pavel Hamet; Stephen Harrap; Neil Poulter; David R Matthews; Michel Marre; John Chalmers Journal: Cardiovasc Diabetol Date: 2016-09-02 Impact factor: 9.951
Authors: Christine Firth; Andrew S Tseng; Mina Abdelmalek; Marlene Girardo; Danish Atwal; Leslie Cooper; Robert McBane; Amy Pollak; David Liedl; Paul Wennberg; Fadi Elias Shamoun Journal: J Am Heart Assoc Date: 2020-05-16 Impact factor: 5.501