School of Medicine, College of Medicine, China Medical University.
Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital.
Circ J. 2018 Apr 25;82(5):1279-1285. doi: 10.1253/circj.CJ-17-0519. Epub 2018 Feb 16.
This retrospective cohort study sought to follow up patients with aplastic anemia (AA) to evaluate their risk of developing atrial fibrillation (AF).
From the National Health Insurance Research Database of Taiwan, this study identified an AA cohort (n=3,921), a general population cohort (n=17,617,843) and a propensity score-matched none AA cohort (PSM non-AA cohort in brief, n=15,684) in 2000-2010. By the end of 2011, the incident AF was higher in the AA cohort than in the general population and PSM non-AA cohorts (8.94 vs. 1.14 and 6.47 per 1,000 person-years, respectively). The adjusted hazards ratio of AF for the AA cohort was 2.12 (95% confidence interval 1.46-3.08) compared with the PSM non-AA cohort, after controlling for covariates. However, after further controlling for the competing risk of death, adjusted subhazard ratio was 1.21 (95% CI 0.97-1.50). Among those who developed AF, the AA cohort had a higher mortality rate (83.7 vs. 51.1 per 100), but a lower rate of incident stroke (26.0 vs. 41.5 per 100), compared with the PSM non-AA cohort.
Patients with AA could have an elevated risk for AF. The mortality risk increased further for those who develop AF.
本回顾性队列研究旨在随访再生障碍性贫血（AA）患者，以评估其发生心房颤动（AF）的风险。
本研究从台湾全民健康保险研究数据库中确定了一个 AA 队列（n=3921）、一个普通人群队列（n=17617843）和一个倾向评分匹配的非 AA 队列（简称 PSM 非 AA 队列，n=15684），入组时间为 2000-2010 年。截止到 2011 年底，AA 队列的新发 AF 发生率高于普通人群和 PSM 非 AA 队列（分别为 8.94、1.14 和 6.47/1000人年）。在控制了协变量后，与 PSM 非 AA 队列相比，AA 队列的 AF 调整后危害比为 2.12（95%置信区间 1.46-3.08）。然而，在进一步控制死亡的竞争风险后，调整后的亚危险比为 1.21（95%CI 0.97-1.50）。在发生 AF 的患者中，与 PSM 非 AA 队列相比，AA 队列的死亡率更高（83.7/100 与 51.1/100），但发生中风的比率更低（26.0/100 与 41.5/100）。
AA 患者发生 AF 的风险可能增加。对于发生 AF 的患者，死亡率进一步增加。
