title: Atrial fibrillation associated with increased risk of venous thromboembolism. A population-based cohort study.
abstract: Whether atrial fibrillation (AF) is associated with an increased risk of venous thromboembolism (VTE) remains controversial. From Longitudinal Health Insurance Database 2000 (LHID2000), we identified 11,458 patients newly diagnosed with AF. The comparison group comprised 45,637 patients without AF. Both cohorts were followed up to measure the incidence of deep-vein thrombosis (DVT) and pulmonary embolism (PE). Univariable and multivariable competing-risks regression model and Kaplan-Meier analyses with the use of Aelon-Johansen estimator were used to measure the differences of cumulative incidences of DVT and PE, respectively. The overall incidence rates (per 1,000 person-years) of DVT and PE between the AF group and non-AF groups were 2.69 vs 1.12 (crude hazard ratio [HR]= 1.92; 95 % confidence interval [CI] = 1.54-2.39), 1.55 vs 0.46 (crude HR = 2.68; 95 % CI = 1.97-3.64), respectively. The baseline demographics indicated that the members of the AF group demonstrated a significantly older age and higher proportions of comorbidities than non-AF group. After adjusting for age, sex, and comorbidities, the risks of DVT and PE remained significantly elevated in the AF group compared with the non-AF group (adjusted HR = 1.74; 95 %CI = 1.36-2.24, adjusted HR = 2.18; 95 %CI = 1.51-3.15, respectively). The Kaplan-Meier curve with the use of Aelon-Johansen estimator indicated that the cumulative incidences of DVT and PE were both more significantly elevated in the AF group than in the non-AF group after a long-term follow-up period (p<0.01). In conclusion, the presence of AF is associated with increased risk of VTE after a long-term follow-up period.
authors.forename: Chun-Cheng
authors.initials: CC
authors.lastname: Wang
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Guei-Jane
authors.initials: GJ
authors.lastname: Wang
authors.forename: Chiz-Tzung
authors.initials: CT
authors.lastname: Chang
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
authors.affiliation: Prof. Chia-Hung Kao, MD, Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 404, Taiwan, Tel.: +886 4 22052121×7412, Fax: +886 4 22336174, E-mail: d10040@mail.cmuh.org.tw.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology*; D016009:Chi-Square Distribution; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000453:epidemiology*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000453:epidemiology*
keywords: Atrial fibrillation; deep-vein thrombosis; population-based cohort study; pulmonary embolism; venous thromboembolism