Association between Atrial Fibrillation and Aortic Aneurysms: A Population-Based Cohort Study

Abstract

Objective: Atrial fibrillation (AF) is the most common form of sustained arrhythmia. Several molecular pathways associated with the pathogenesis of AF also participate in the initiation and progression of aortic aneurysm (AA). In this study, we aimed to evaluate potential associations between AA and AF. Patients and Methods: The data for this nationwide population-based retrospective cohort study were obtained from Taiwan’s National Health Insurance Research Database (NHIRD). All medical conditions for each case and the controls were categorized using the 9th revision of the International Classification of Diseases (ICD-9). Odds ratios and 95% confidence intervals for associations between AF and AA were estimated using Cox regression and adjusted for comorbidities. Results: Our analyses included 116,225 AF cases and 116,225 propensity score-matched controls. Compared with the controls, the patients with AF exhibited a significantly increased risk of developing an AA (adjusted hazard ratio, HR 1.243, p < 0.001). Another cohort of 19,776 patients diagnosed with AA were identified, and 19,776 propensity score-matched patients were included as controls. Patients who had AA were also at an increased risk of developing AF (adjusted HR 1.187, p < 0.001). Heart failure (HF) was a common risk factor for both AA and AF. Conclusion: There are associations between AF and AA. HF is a mutual risk factor for the development of AF and AA.

Diagnostic and predictive values of circulating tetrahydrobiopterin levels as a novel biomarker in patients with thoracic and abdominal aortic aneurysms

“…As shown in Table 4 , 7 out of 44 (15.9%) control subjects have arrhythmia, whereas 13 out of 29 (44.8%) AAA subjects have co-existing arrhythmia ( Table 4 ) (p = 0.007). This seems to share some similarities with previous reports that patients with atrial fibrillation, the most common form of arrhythmia, have increased risk of developing aortic aneurysms (adjusted hazard ratio 1.243, p < 0.001) [ 45 ]. In addition, others have also reported presence of dilated aortic root or ascending thoracic aorta in patients with atrial fibrillation [ 46 ].…”

Stroke and Myocardial Infarction in Patients with Abdominal Aortic Aneurysm and New-Onset Atrial Fibrillation

“…40,41 Yet at present, there is no recommendation on screening for AF in patients with AAA, as opposed to recommendations in patients with symptomatic atherosclerotic peripheral arterial disease. 4 Given the high and increasing prevalence of AF in the general population (2-5%) 4,42 as well as among patients with AAA (up to 12.5%), 11,43 it might be prudent to incorporate AF screening in the management of patients with AAA.…”

“…prevalence of AF in the general population (2-5%) 11,43 as well as among patients with AAA (up to 12.5%), 12,44 it might be prudent to incorporate AF screening in the management of patients with AAA.…”

Proximal aorta dilatation in hypertension

“…Another prospective cohort study further elucidated that aortic dilation and AF were mutual risk factors for each other [91]. The potential mechanisms of this interrelationship may be due to the similar cardiovascular risk factors (like age, hypertension, LVH, obesity, and smoking, and the shared pathogenic pathways (including pressure overload, RAAS activation, inflammation and fibrosis [91].…”