Causes of Death and Influencing Factors in Patients with Atrial Fibrillation

Fauchier, Laurent; Villejoubert, Olivier; Clémenty, Nicolas; Bernard, Anne; Pierre, Bertrand; Angoulvant, Denis; Ivanès, Fabrice; Babuty, Dominique; Lip, Gregory Y.H.

doi:10.1016/j.amjmed.2016.06.045

Cited by 160 publications

(120 citation statements)

References 34 publications

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“…Nevertheless, the association between atrial fibrillation and flutter and suicide was strengthened by the excess rate within the first 6 months and in combination with comorbid disorders. The high comorbidity linked to atrial fibrillation, for instance, in the form of heart failure and thromboembolic strokes , might contribute to the high rate; however, stroke was included in the comorbidity index used in the adjusted model. Other contributing factors could be the psychological distress associated with having a chronic disease and the continued symptoms.…”

Section: Discussionmentioning

confidence: 99%

The association between heart diseases and suicide: a nationwide cohort study

et al. 2020

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Objective To assess the association between specific heart diseases and suicide. Design Nationwide retrospective cohort study. Participants A total of 7 298 002 individuals (3 640 632 males and 3 657 370 females) aged ≥15 years and living in Denmark during 1980–2016. Main outcome measures Incidence rate ratios (IRR) with 95% confidence intervals. In multivariate analysis, we adjust for sex, period, age group, living status, income level, Charlson Comorbidity Index, psychiatric disorders prior to heart disease and self‐harm prior to heart disease. Results Excess suicide rate ratios were found for following disorders: heart failure (IRR: 1.48; 95% CI: 1.38–1.58); cardiomyopathy (IRR: 1.41; 95% CI: 1.16–1.70); acute myocardial infarction (IRR: 1.28; 95% CI: 1.21–1.36); cardiac arrest with successful resuscitation (IRR: 4.75; 95% CI: 3.57–6.33); atrial fibrillation and flutter (IRR: 1.42; 95% CI: 1.32–1.52); angina pectoris (IRR: 1.19; 95% CI: 1.12–1.26); and ventricular tachycardia (IRR: 1.53; 95% CI: 1.20–1.94). A higher rate of suicide was noted during the first 6 months after the diagnosis of heart failure (IRR: 2.38; 95% CI: 2.04–2.79); acute myocardial infarction (IRR: 2.24; 95% CI: 1.89–2.66); atrial fibrillation and flutter (IRR: 2.70; 95% CI: 2.30–3.18); and angina pectoris (IRR: 1.83; 95% CI: 1.53–2.19) when compared to later. Conclusion Several specific disorders were found to be associated with elevated rates of suicide. Additionally, we found temporal associations with higher suicide rates in the first time after diagnosis. Our results underscore the importance of being attentive towards psychological distress in individuals with heart disease.

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Section: Discussionmentioning

confidence: 99%

The association between heart diseases and suicide: a nationwide cohort study

et al. 2020

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“…The increased risk of death and CV death, even despite OAC use, has been highlighted in several previous studies [3,9,13,14]. AF patients may be progressively more clinically complex, due to the progressively increasing age and the higher prevalence of major CV diseases, partly explaining the increase in CV death.…”

Section: Multivariate Regression and Survival Analysesmentioning

confidence: 96%

“…Finally, there was a significant decrease in rates of both thromboembolic and major CV events, but a significant increase in all-cause and CV mortality.Both AF prevalence and incidence rise according to increasing age, and particularly in elderly and very elderly patients[1]. Importantly, increasing age increases morbidity and mortality in AF patients[12,13]. A similar analysis of trends in AF patients admitted to Medicare beneficiaries in USA, showed that from 1999 to 2013 there was a progressive increase in age and proportion of very elderly patients (age ≥85 years)[4].Proportionally, various comorbidities were increased among European AF patients.…”

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confidence: 91%

Increased burden of comorbidities and risk of cardiovascular death in atrial fibrillation patients in Europe over ten years: A comparison between EORP-AF pilot and EHS-AF registries

Proietti

Laroche

Nieuwlaat

et al. 2018

European Journal of Internal Medicine

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“…Fauchier et al [24] reported that among 8,962 patients with incident AF, majority of deaths during follow-up were related to cardiovascular disease (54%), and heart failure (29%) was specifically noted to be the most common cause of death. Notably, despite the high risk of stroke with AF, only 7% died from stroke [24]. GomezOutez et al [25] pooled data from 4 clinical trials representing 71,683 patients with AF.…”

Section: Discussionmentioning

confidence: 99%

Cause-Specific Mortality in Patients with Chronic Kidney Disease and Atrial Fibrillation

et al. 2018

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Background: Atrial fibrillation (AF) is associated with death in patients with chronic kidney disease (CKD). We examined the associations between AF and cause-specific mortality in a large CKD population. Methods: We included 62,459 patients with estimated glomerular filtration rate 15–59 mL/min/1.73 m² (6,639 patients with AF and 55,820 without AF) followed in a large health care system. Outcomes included overall and cause-specific deaths (a) cardiovascular; (b) malignancy; and (c) non-cardiovascular/non-malignancy causes. Cox regression models for overall mortality and separate competing risk models for each major cause of death category were used to evaluate their respective associations with AF. Results: During a median follow-up of 4.1 years, 19,094 patients died; cause of death was known for 18,854 patients. After multivariable adjustment (demographics, comorbidities, relevant laboratory data, medication use, and kidney function), AF was associated with 23% (95% CI 18–29%) higher risk of all-cause mortality, 45% (95% CI 31–61%) higher risk of cardiovascular mortality and 13% (95% CI 3–22%) lower risk of malignancy-related mortality. Exclusion of patients with malignancy yielded similar results except for a lack of association between AF and malignancy-related deaths. Results were consistent across various stages of CKD. Conclusions: In a non-dialysis-dependent CKD population, the presence of AF was associated with higher all-cause and cardiovascular mortality. These data suggest that patients with both CKD and AF are at high cardiovascular risk, and thus clinical practice (or trials) should aim at reducing the overall excess cardiovascular mortality (not stroke alone) in patients with AF and CKD.

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Causes of Death and Influencing Factors in Patients with Atrial Fibrillation

Cited by 160 publications

References 34 publications

The association between heart diseases and suicide: a nationwide cohort study

The association between heart diseases and suicide: a nationwide cohort study

Increased burden of comorbidities and risk of cardiovascular death in atrial fibrillation patients in Europe over ten years: A comparison between EORP-AF pilot and EHS-AF registries

Cause-Specific Mortality in Patients with Chronic Kidney Disease and Atrial Fibrillation

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