Key result
Aortic dissection is bidirectionally linked to atrial fibrillation, predicting ~74% higher incident AF risk.
Why the study?
The study was conducted to explore the link between aortic dissection and atrial fibrillation.
Is there a bidirectional association between aortic dissection and atrial fibrillation?
Cohort (n=404,614)
Is there a bidirectional association between aortic dissection and atrial fibrillation?
Hazard Ratio: 1.74 (95% CI 1.53–1.98)
Absolute Event Rate: 11.1% vs 8.3%
There is a bidirectional association between aortic dissection and atrial fibrillation, with each condition significantly increasing the risk of developing the other.
Observed bidirectional association between aortic dissection and atrial fibrillation should not change practice; hypothesis-generating and requires prospective confirmation.
OBJECTIVE: To explore the link between aortic dissection (AD) and atrial fibrillation (AF). METHODS: Using the National Health Insurance Research Database (NHIRD), cohorts were constructed for evaluating the incidence of AF in patients with AD (study 1) and the incident AD among AF patients (study 2) based on propensity matching analysis. Cox proportion hazard regression models were used to examine the effect of AD on the risk of AF, shown as hazard ratios (HRs) with 95% confidence intervals (CIs). Similar statistical procedures were used for study 2. RESULTS: The study 1 consisted of 11 813 patients in the AD cohort and 11 813 controls in the non-AD cohort and the study 2 consisted of 190 494 patients in the AF cohort and 190 494 controls in the non-AF cohort. The overall incidence density of AF was 1.32-fold higher in the AD cohort than in the non-AD cohort (11.1 and 8.3 per 1000 person-years), with an adjusted HR (aHR) of 1.74 (95% CI = 1.53-1.98). The AF cohort had 1.18-fold higher incidence of AD than the non-AF cohort (0.55 vs 0.47 per 1000 person-years), with an aHR of 1.24 (95% CI = 1.07-1.44). CONCLUSIONS: Bidirectional association between AD and AF was shown for the first time in this study.
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Hu et al. (2019) conducted a cohort in Aortic dissection and atrial fibrillation (n=404,614). Aortic dissection vs. Non-aortic dissection was evaluated on Incidence of atrial fibrillation (HR 1.74, 95% CI 1.53-1.98). Aortic dissection increased the risk of incident atrial fibrillation (HR 1.74; 95% CI 1.53-1.98), and atrial fibrillation increased the risk of incident aortic dissection (HR 1.24; 95% CI 1.07-1.44).