Aplastic Anemia and Risk of Incident Atrial Fibrillation　― A Nationwide Cohort Study ―

Abstract

Background: This retrospective cohort study sought to follow up patients with aplastic anemia (AA) to evaluate their risk of developing atrial fibrillation (AF). Methods and Results:From the National Health Insurance Research Database of Taiwan, this study identified an AA cohort (n=3,921), a general population cohort (n=17,617,843) and a propensity score-matched none AA cohort (PSM non-AA cohort in brief, n=15,684) in 2000-2010. By the end of 2011, the incident AF was higher in the AA cohort than in the general population and PSM non-AA cohorts (8.94 vs. 1.14 and 6.47 per 1,000 person-years, respectively). The adjusted hazards ratio of AF for the AA cohort was 2.12 (95% confidence interval 1.46-3.08) compared with the PSM non-AA cohort, after controlling for covariates. However, after further controlling for the competing risk of death, adjusted subhazard ratio was 1.21 (95% CI 0.97-1.50). Among those who developed AF, the AA cohort had a higher mortality rate (83.7 vs. 51.1 per 100), but a lower rate of incident stroke (26.0 vs. 41.5 per 100), compared with the PSM non-AA cohort. Conclusions:Patients with AA could have an elevated risk for AF. The mortality risk increased further for those who develop AF.

Impact of Hemoglobin Levels and Their Dynamic Changes on the Risk of Atrial Fibrillation: A Nationwide Population-Based Study

“…Among subjects with acute myocardial infarction, those who developed AF showed a significantly higher hemoglobin level compared with those without AF (14.2 g/dl, IQR 12.4-15 vs. 12.9 g/dl, IQR 11.7-13.8; P < 0.001). The other is a nationwide cohort study of aplastic anemia in Taiwan 15 . Patients with aplastic anemia had a higher risk of incident AF compared with the general population after controlling for the competing risk of death (HR 1.21, 95% CI 0.97-1.50).…”

Increased risk of atrial fibrillation in patients with benign prostatic hyperplasia: A population‐based cohort study

“…Based on our results, AF is a common finding in these patients with possible implications, but rather less consequence once the acute situation is overcome. It is well appreciated that specific situations like inflammation, surgical stress, and other severe medical circumstances may act as “modulators” leading to incident AF . The detailed pathophysiological mechanisms leading to the link between BPH and AF are difficult to propose because of the inherent nature of observational association studies.…”

Gastrointestinal Bleeding and Direct Oral Anticoagulants among Patients with Atrial Fibrillation: Risk, Prevention, Management, and Quality of Life

“… 43 Anemia is often seen in patients with AF, and it could possibly be linked to a greater risk of new-onset AF. 44 45 VKAs also put patients with anemia at a greater risk of bleeding. 46 47 48 However, majority of randomized controlled trials of DOACs have not included patients with hemoglobin <10 g/dL.…”