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What do patients with incident atrial fibrillation and no comorbidities at the time of diagnosis die of?
Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
Department of Occupational and Environmental Medicine, Örebro University, Örebro, Sweden.
Clinical Epidemiology and Biostatistics, Örebro University, Örebro, Sweden.
Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
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2017 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Introduction: Little is known about the long-term mortality risk and the causes of death in patients without comorbidities at the time of diagnosis of atrial fibrillation (AF).

Purposes: To identify the causes of death in patients with AF and without comorbidities at the time of AF diagnosis.

Methods: We identified 9 519 patients with first diagnosed AF and no co-morbidities at the time of AF diagnosis in a nation-wide registry of patients hospitalized between 1995 and 2008. They represented 3.5% of the original cohort of 271186 patients hospitalized with incident AF. Patients with any diagnosis from ICD9 and ICD10 at the time of AF diagnosis wereexcluded. They were matched for age, sex and calendar year of AF diagnosis with 12 468 controls. The follow-up continued until December 2008. Causes of death were classified according to the ICD-10 codes.

Results: During follow-up, 11.1% and 8.3% of patients with AF and controls died, HR 1.3, 95% CI 1.2–1.4. Most of the difference was explained by deaths of cardiovascular causes, 8.3% versus 3.9%, (HR 2.0, 95% CI 1.8–2.3). The cause of death pattern was the same in controls although at much lower rates. The age adjusted relative risk was higher in women than in men, HR 2.3, 95% CI 1.9–2.8 versus HR 1.7, 95% CI 1.4–2.0. Myocardial infarction was the most common cardiovascular cause of death but was less common among patients with AF than in controls, 20.5% versus 32.0%. Stroke was a more common cause among patients with AF, 13.1% versus 9.7% (HR 2.7, 95% CI 1.8–4.0), while cerebral hemorrhage was more common among controls, 4.7% versus 10.2% (HR 0.9, 95% CI 0.6–1.5). The time from AF diagnosis to death was 6.0±3.1 years, as compared to the time from inclusion to death, 5.8±3.1 years, in controls.

Conclusions: Only cardiovascular diseases were more often causes of death than in controls. Women carried a significantly higher relative risk than men. The duration between AF diagnosis and death suggests that there is often time enough for early intervention with antithrombotic therapy, rhythm and/or rate control and treatment of risk factors as they appear. Interestingly, controls had the same cause of death pattern although at much lower rates.

Place, publisher, year, edition, pages
European Society of Cardiology , 2017.
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:oru:diva-69462OAI: oai:DiVA.org:oru-69462DiVA, id: diva2:1254617
Conference
European Society of Cardiology Congress 2017, Barcelona, Spain, August 26-30, 2017
Available from: 2018-10-09 Created: 2018-10-09 Last updated: 2019-04-02Bibliographically approved

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Fröbert, OlePoci, Dritan

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