Atrial fibrillation, liver cirrhosis, thrombosis, and bleeding: A Danish population‐based cohort study
Abstract Objectives We examined the impact of liver cirrhosis on the risk of thromboembolic events and bleeding complications in patients with atrial fibrillation or flutter (AFF). Methods This population‐based cohort study used data from Danish health registries. We identified all patients with a f...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-02-01
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| Series: | Research and Practice in Thrombosis and Haemostasis |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/rth2.12668 |
| _version_ | 1797712327152238592 |
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| author | Emil B.Riahi Kasper Adelborg Lars Pedersen Søren R. Kristensen Anette T. Hansen Henrik T. Sørensen |
| author_facet | Emil B.Riahi Kasper Adelborg Lars Pedersen Søren R. Kristensen Anette T. Hansen Henrik T. Sørensen |
| author_sort | Emil B.Riahi |
| collection | DOAJ |
| description | Abstract Objectives We examined the impact of liver cirrhosis on the risk of thromboembolic events and bleeding complications in patients with atrial fibrillation or flutter (AFF). Methods This population‐based cohort study used data from Danish health registries. We identified all patients with a first‐time diagnosis of AFF during 1995 to 2015, and followed them from their AFF diagnosis until the end of 2016. Patients were categorized according to the presence or absence of liver cirrhosis. We computed incidence rates per 1000 person‐years and hazard ratios (HRs) with 95% confidence intervals (CIs) based on Cox regression analyses, adjusting for age, CHA2DS2VASc score, and Charlson Comorbidity Index score. Results We identified 273 225 patients with AFF. Of these, 1463 (0.54%) had liver cirrhosis. During 0 to 5 years of follow‐up, compared to patients without liver cirrhosis, patients with liver cirrhosis had higher incidence rates and hazards of ischemic stroke (29.7 vs 21.6; HR, 1.3; 95% CI, 1.1‐1.6), venous thromboembolism (9.2 vs 5.5; HR, 1.5; 95% CI, 1.2‐2.3), but not myocardial infarction (10.2 vs 11.2; HR, 0.9; 95% CI, 0.7–1.2). Patients with liver cirrhosis also had higher rates of hemorrhagic stroke (5.8 vs 3.3; HR, 1.7; 95% CI, 1.1‐2.6), subdural hemorrhage (5.3 vs 1.6; HR, 3.2; 95% CI, 2.1‐4.9), hemorrhage of the lung or urinary tract (24.6 vs 15.2; HR, 1.6; 95% CI, 1.3–2.0), and gastrointestinal hemorrhage (34.5 vs 10.4; HR, 3.3; 95% CI, 2.7–3.9). Conclusion In patients with AFF, liver cirrhosis was associated with an elevated risk of ischemic stroke, venous thromboembolism, and all evaluated bleeding complications. |
| first_indexed | 2024-03-12T07:20:06Z |
| format | Article |
| id | doaj.art-4985e5995920453ab5fa7afbf985b438 |
| institution | Directory Open Access Journal |
| issn | 2475-0379 |
| language | English |
| last_indexed | 2024-03-12T07:20:06Z |
| publishDate | 2022-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Research and Practice in Thrombosis and Haemostasis |
| spelling | doaj.art-4985e5995920453ab5fa7afbf985b4382023-09-02T22:33:20ZengElsevierResearch and Practice in Thrombosis and Haemostasis2475-03792022-02-0162n/an/a10.1002/rth2.12668Atrial fibrillation, liver cirrhosis, thrombosis, and bleeding: A Danish population‐based cohort studyEmil B.Riahi0Kasper Adelborg1Lars Pedersen2Søren R. Kristensen3Anette T. Hansen4Henrik T. Sørensen5Department of Clinical Epidemiology Aarhus University Hospital and Aarhus University Aarhus DenmarkDepartment of Clinical Epidemiology Aarhus University Hospital and Aarhus University Aarhus DenmarkDepartment of Clinical Epidemiology Aarhus University Hospital and Aarhus University Aarhus DenmarkThe Atrial Fibrillation Study Group Aalborg University Hospital Aalborg DenmarkDepartment of Clinical Epidemiology Aarhus University Hospital and Aarhus University Aarhus DenmarkDepartment of Clinical Epidemiology Aarhus University Hospital and Aarhus University Aarhus DenmarkAbstract Objectives We examined the impact of liver cirrhosis on the risk of thromboembolic events and bleeding complications in patients with atrial fibrillation or flutter (AFF). Methods This population‐based cohort study used data from Danish health registries. We identified all patients with a first‐time diagnosis of AFF during 1995 to 2015, and followed them from their AFF diagnosis until the end of 2016. Patients were categorized according to the presence or absence of liver cirrhosis. We computed incidence rates per 1000 person‐years and hazard ratios (HRs) with 95% confidence intervals (CIs) based on Cox regression analyses, adjusting for age, CHA2DS2VASc score, and Charlson Comorbidity Index score. Results We identified 273 225 patients with AFF. Of these, 1463 (0.54%) had liver cirrhosis. During 0 to 5 years of follow‐up, compared to patients without liver cirrhosis, patients with liver cirrhosis had higher incidence rates and hazards of ischemic stroke (29.7 vs 21.6; HR, 1.3; 95% CI, 1.1‐1.6), venous thromboembolism (9.2 vs 5.5; HR, 1.5; 95% CI, 1.2‐2.3), but not myocardial infarction (10.2 vs 11.2; HR, 0.9; 95% CI, 0.7–1.2). Patients with liver cirrhosis also had higher rates of hemorrhagic stroke (5.8 vs 3.3; HR, 1.7; 95% CI, 1.1‐2.6), subdural hemorrhage (5.3 vs 1.6; HR, 3.2; 95% CI, 2.1‐4.9), hemorrhage of the lung or urinary tract (24.6 vs 15.2; HR, 1.6; 95% CI, 1.3–2.0), and gastrointestinal hemorrhage (34.5 vs 10.4; HR, 3.3; 95% CI, 2.7–3.9). Conclusion In patients with AFF, liver cirrhosis was associated with an elevated risk of ischemic stroke, venous thromboembolism, and all evaluated bleeding complications.https://doi.org/10.1002/rth2.12668atrial fibrillationcohort studyhemorrhagic strokeischemic strokeliver cirrhosisvenous thromboembolism |
| spellingShingle | Emil B.Riahi Kasper Adelborg Lars Pedersen Søren R. Kristensen Anette T. Hansen Henrik T. Sørensen Atrial fibrillation, liver cirrhosis, thrombosis, and bleeding: A Danish population‐based cohort study Research and Practice in Thrombosis and Haemostasis atrial fibrillation cohort study hemorrhagic stroke ischemic stroke liver cirrhosis venous thromboembolism |
| title | Atrial fibrillation, liver cirrhosis, thrombosis, and bleeding: A Danish population‐based cohort study |
| title_full | Atrial fibrillation, liver cirrhosis, thrombosis, and bleeding: A Danish population‐based cohort study |
| title_fullStr | Atrial fibrillation, liver cirrhosis, thrombosis, and bleeding: A Danish population‐based cohort study |
| title_full_unstemmed | Atrial fibrillation, liver cirrhosis, thrombosis, and bleeding: A Danish population‐based cohort study |
| title_short | Atrial fibrillation, liver cirrhosis, thrombosis, and bleeding: A Danish population‐based cohort study |
| title_sort | atrial fibrillation liver cirrhosis thrombosis and bleeding a danish population based cohort study |
| topic | atrial fibrillation cohort study hemorrhagic stroke ischemic stroke liver cirrhosis venous thromboembolism |
| url | https://doi.org/10.1002/rth2.12668 |
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