Anna Gundlund1, Thomas Kümler2, Jonas Bjerring Olesen3, Anders Nissen Bonde3, Gunnar H Gislason4, Christian Torp-Pedersen5, Lars Køber6, Emil Loldrup Fosbøl6. 1. Department of Cardiology, Research Unit 1, Copenhagen University Hospital Herlev-Gentofte, Kildegaardsvej 28, Hellerup, Denmark. Electronic address: annagundlund@gmail.com. 2. Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Herlev Ringvej 75, Herlev, Denmark. 3. Department of Cardiology, Research Unit 1, Copenhagen University Hospital Herlev-Gentofte, Kildegaardsvej 28, Hellerup, Denmark. 4. Department of Cardiology, Research Unit 1, Copenhagen University Hospital Herlev-Gentofte, Kildegaardsvej 28, Hellerup, Denmark; The Danish Heart Foundation, Vognmagergade 7, Copenhagen K, Denmark; The National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, Copenhagen K, Denmark. 5. Department of Health, Science and Technology, Aalborg University, and departments of Cardiology and Epidemiology/Biostatistics, Aalborg University Hospital, Frederik Bajers Vej 7 D2, Aalborg, east, Denmark. 6. Department of Cardiology, University Hospital of Copenhagen, Rigshospitalet, Blegdamsvej 9, Copenhagen Ø, Denmark.
Abstract
BACKGROUND: The aim of this study was to compare long-term thromboembolic risk in infection-related and non-infection-related atrial fibrillation (AF). METHODS: Using Danish nationwide registries, we identified patients with first-time AF from 1996-2015 and performed a retrospective cohort study. We did a 1:1 match (upon sex, age, calendar year, and oral anticoagulation (OAC) status at the beginning of follow-up) of patients with infection-related (concurrent discharge diagnosis code for infection) and non-infection-related AF. Long-term outcomes were examined using multivariable Cox regression analyses. RESULTS: Our study population comprised 48,644 patients equally distributed on infection-related and non-infection-related AF. In both groups, those initiated on OAC therapy were younger than those not initiated on OAC therapy (median age 77 years, interquartile range 69-83 versus median age 79 years, interquartile range 71-86). During the 1st year of follow up, infection-related AF was associated with an increased risk of thromboembolic events compared with non-infection-related AF: adjusted hazard ratio (HR) 1.44 (95% confidence interval (CI) 1.16-1.78) for those initiated on OAC therapy and HR 1.17 (95% CI 1.06-1.28) for those not initiated on OAC therapy. In both groups, OAC therapy was associated with better outcomes than no OAC therapy (HR of thromboembolic events 0.75 (95% CI 0.68-0.83) and HR 0.70 (95% CI 0.63-0.78) for patients with infection-related and non-infection-related AF, respectively). CONCLUSION: Infection was associated with an increased thromboembolic risk in patients with first-time AF. OAC therapy was associated with a similar risk-reduction in AF patients with and without a concurrent infection.
BACKGROUND: The aim of this study was to compare long-term thromboembolic risk in infection-related and non-infection-related atrial fibrillation (AF). METHODS: Using Danish nationwide registries, we identified patients with first-time AF from 1996-2015 and performed a retrospective cohort study. We did a 1:1 match (upon sex, age, calendar year, and oral anticoagulation (OAC) status at the beginning of follow-up) of patients with infection-related (concurrent discharge diagnosis code for infection) and non-infection-related AF. Long-term outcomes were examined using multivariable Cox regression analyses. RESULTS: Our study population comprised 48,644 patients equally distributed on infection-related and non-infection-related AF. In both groups, those initiated on OAC therapy were younger than those not initiated on OAC therapy (median age 77 years, interquartile range 69-83 versus median age 79 years, interquartile range 71-86). During the 1st year of follow up, infection-related AF was associated with an increased risk of thromboembolic events compared with non-infection-related AF: adjusted hazard ratio (HR) 1.44 (95% confidence interval (CI) 1.16-1.78) for those initiated on OAC therapy and HR 1.17 (95% CI 1.06-1.28) for those not initiated on OAC therapy. In both groups, OAC therapy was associated with better outcomes than no OAC therapy (HR of thromboembolic events 0.75 (95% CI 0.68-0.83) and HR 0.70 (95% CI 0.63-0.78) for patients with infection-related and non-infection-related AF, respectively). CONCLUSION: Infection was associated with an increased thromboembolic risk in patients with first-time AF. OAC therapy was associated with a similar risk-reduction in AFpatients with and without a concurrent infection.
Authors: Mette Søgaard; Flemming Skjøth; Peter B Nielsen; Jesper Smit; Michael Dalager-Pedersen; Torben B Larsen; Gregory Y H Lip Journal: JAMA Netw Open Date: 2022-05-02
Authors: A Gundlund; Thomas Kümler; Anders Nissen Bonde; Jawad Haider Butt; Gunnar Hilmar Gislason; Christian Torp-Pedersen; Lars Køber; Jonas Bjerring Olesen; Emil Loldrup Fosbøl Journal: BMJ Open Date: 2019-09-20 Impact factor: 2.692