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Comparative thromboembolic risk in atrial fibrillation patients with and without a concurrent infection

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@article{04aabcb257ba44cc848ff8f59f241e32,
title = "Comparative thromboembolic risk in atrial fibrillation patients with and without a concurrent infection",
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.",
author = "Anna Gundlund and Thomas K{\"u}mler and Olesen, {Jonas Bjerring} and Bonde, {Anders Nissen} and Gislason, {Gunnar H} and Christian Torp-Pedersen and Lars K{\o}ber and Fosb{\o}l, {Emil Loldrup}",
note = "Copyright {\textcopyright} 2018 Elsevier Inc. All rights reserved.",
year = "2018",
month = oct,
doi = "10.1016/j.ahj.2018.07.003",
language = "English",
volume = "204",
pages = "43--51",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby, Inc",

}

RIS

TY - JOUR

T1 - Comparative thromboembolic risk in atrial fibrillation patients with and without a concurrent infection

AU - Gundlund, Anna

AU - Kümler, Thomas

AU - Olesen, Jonas Bjerring

AU - Bonde, Anders Nissen

AU - Gislason, Gunnar H

AU - Torp-Pedersen, Christian

AU - Køber, Lars

AU - Fosbøl, Emil Loldrup

N1 - Copyright © 2018 Elsevier Inc. All rights reserved.

PY - 2018/10

Y1 - 2018/10

N2 - 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.

AB - 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.

U2 - 10.1016/j.ahj.2018.07.003

DO - 10.1016/j.ahj.2018.07.003

M3 - Journal article

C2 - 30075325

VL - 204

SP - 43

EP - 51

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

ER -

ID: 56240438