Hsu Chia-Ching, Chien Wu-Chien, Wang Jen-Chun, Chung Chi-Hsiang, Liao Wen-I, Lin Wei-Shiang, Lin Chin-Sheng, Tsai Shih-Hung
Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
J Vasc Res. 2018;55(5):299-307. doi: 10.1159/000493692. Epub 2018 Oct 22.
Atrial fibrillation (AF) is the most common form of sustained arrhythmia. Several molecular pathways associated with the pathogenesis of AF also participate in the initiation and progression of aortic aneurysm (AA). In this study, we aimed to evaluate potential associations between AA and AF.
The data for this nationwide population-based retrospective cohort study were obtained from Taiwan's National Health Insurance Research Database (NHIRD). All medical conditions for each case and the controls were categorized using the 9th revision of the International Classification of Diseases (ICD-9). Odds ratios and 95% confidence intervals for associations between AF and AA were estimated using Cox regression and adjusted for comorbidities.
Our analyses included 116,225 AF cases and 116,225 propensity score-matched controls. Compared with the controls, the patients with AF exhibited a significantly increased risk of developing an AA (adjusted hazard ratio, HR 1.243, p < 0.001). Another cohort of 19,776 patients diagnosed with AA were identified, and 19,776 propensity score-matched patients were included as controls. Patients who had AA were also at an increased risk of developing AF (adjusted HR 1.187, p < 0.001). Heart failure (HF) was a common risk factor for both AA and AF.
There are associations between AF and AA. HF is a mutual risk factor for the development of AF and AA.
心房颤动（AF）是持续性心律失常最常见的形式。与AF发病机制相关的几种分子途径也参与了主动脉瘤（AA）的发生和发展。在本研究中，我们旨在评估AA与AF之间的潜在关联。
这项基于全国人群的回顾性队列研究的数据来自台湾国民健康保险研究数据库（NHIRD）。每个病例和对照的所有医疗状况均使用国际疾病分类第九版（ICD-9）进行分类。使用Cox回归估计AF与AA之间关联的比值比和95%置信区间，并对合并症进行调整。
我们的分析纳入了116,225例AF病例和116,225例倾向评分匹配的对照。与对照组相比，AF患者发生AA的风险显著增加（调整后的风险比，HR 1.243，p < 0.001）。另外确定了一组19,776例被诊断为AA的患者，并纳入19,776例倾向评分匹配的患者作为对照。患有AA的患者发生AF的风险也增加（调整后的HR 1.187，p < 0.001）。心力衰竭（HF）是AA和AF的常见危险因素。
AF与AA之间存在关联。HF是AF和AA发生的共同危险因素。
