Acute dental periapical abscess and new-onset atrial fibrillation: A nationwide, population-based cohort study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Hassan ◽  
G Lip ◽  
A Bisson ◽  
J Herbert ◽  
A Bodin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
National Database ◽  
Increased Risk ◽  
Periapical Abscess ◽  
Onset Atrial Fibrillation ◽  
New Onset

Abstract Funding Acknowledgements Type of funding sources: None. Background There are limited data on whether there is an association between hospitalisation with dental periapical abscess and new-onset atrial fibrillation (AF) which is independent of main cardiovascular risk factors. Purpose To investigate whether there is an association between hospitalisation with dental periapical abscess and new-onset AF. Methods A retrospective cohort study from a national database of patients hospitalised in 2013 (3.4 million patients) with at least five years of follow up, unless deceased. International Classification of Diseases (ICD) codes were used to compare the risk of developing new-onset AF for adults with and without dental periapical abscesses using univariate and multivariable analysis and hazard ratios (HR). Results In total, 4,693 patients classified as having dental periapical abscess, 435 (9.27%) developed AF, compared to 326,241 (10.69%) without dental periapical abscess over a mean follow-up of 4.8 ± 1.7 years.  Multivariable analysis indicated that dental periapical abscess acted as an independent predictor for new onset AF (p < 0.01). Conclusions An increased risk of new onset AF was identified for individuals hospitalised with dental periapical abscess. Careful follow up of patients with severe, acute dental periapical infections are needed for incident AF, as well as investigations of possible mechanisms linking these conditions. Predictors of new-onset AF during FU Univariate analysis Multivariate analysis HR, 95%CI P HR, 95%CI P Age, years 1.077 (1.076-1.077) <0.0001 1.076 (1.075-1.076) <0.0001 Gender (male) 1.640 (1.629-1.651) <0.0001 1.0498 (1.487-1.509) <0.0001 Hypertension 2.849 (2.829-2.869) <0.0001 1.114 (1.487-1.509) <0.0001 Diabetes mellitus 1.951 (1.935-1.968) <0.0001 1.106 (1.096-1.116) <0.0001 Heart failure 3.893 (3.857-3.930) <0.0001 1.434 (1.416-1.452) <0.0001 Ischaemic stroke 2.289 (2.23902.340) <0.0001 1.140 (1.114-1.165) <0.0001 smoker 0.903 (0.891-0.917) <0.0001 1.052 (1.036-1.069) <0.0001 Liver disease 1.141 (1.119-1.164) <0.0001 1.082 (1.059-1.105) <0.0001 Previous myocardial infarction 2.128 (2.082-2.176) <0.0001 0.903 (0.880-0.926) <0.0001 Inflammatory disease 1.036 (1.020-1.052) <0.0001 0.978 (0.964-0.994) 0.005 Cognitive impairment 2.368 (2.326-2.410) <0.0001 0.821 (0.807-0.836) <0.0001 Illicit drug use 0.288 (0.263-0.317) <0.0001 0.940 (0.855-1032) 0.19 Dental periapical abscess 0.855 (0.778- 0.939) 0.001 1.107 (1.008-1.216) 0.03 At least 5 years of follow-up (mean follow-up 4.8 ± 1.7 years). Abstract Figure. Flow Chart of the study patients

scholarly journals Acute Dental Periapical Abscess and New-Onset Atrial Fibrillation: A Nationwide, Population-Based Cohort Study

2021 ◽  
Vol 10 (13) ◽  
pp. 2927
Author(s):  
Amaar Obaid Hassan ◽  
Gregory Y. H. Lip ◽  
Arnaud Bisson ◽  
Julien Herbert ◽  
Alexandre Bodin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Multivariable Analysis ◽  
National Database ◽  
Increased Risk ◽  
Periapical Abscess ◽  
The Relationship ◽  
Onset Atrial Fibrillation ◽  
New Onset

There are limited data on the relationship of acute dental infections with hospitalisation and new-onset atrial fibrillation (AF). This study aimed to assess the relationship between acute periapical abscess and incident AF. This was a retrospective cohort study from a French national database of patients hospitalized in 2013 (3.4 million patients) with at least five years of follow up. In total, 3,056,291 adults (55.1% female) required hospital admission in French hospitals in 2013 while not having a history of AF. Of 4693 patients classified as having dental periapical abscess, 435 (9.27%) developed AF, compared to 326,241 (10.69%) without dental periapical abscess that developed AF over a mean follow-up of 4.8 ± 1.7 years. Multivariable analysis indicated that dental periapical abscess acted as an independent predictor for new onset AF (p < 0.01). The CHA2DS2VASc score in patients with acute dental periapical abscess had moderate predictive value for development of AF, with Area Under the Curve (AUC) 0.73 (95% CI, 0.71–0.76). An increased risk of new onset AF was identified for individuals hospitalized with dental periapical abscess. Careful follow up of patients with severe, acute dental periapical infections is needed for incident AF, as well as investigations of possible mechanisms linking these conditions.

scholarly journals Gender-specific relationship between abdominal obesity and prevalence of new-onset atrial fibrillation in the general Japanese population

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Ninomiya ◽  
S Kawasoe ◽  
H Ichiki ◽  
T Kubozono ◽  
H Miyahara ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Waist Circumference ◽  
Abdominal Obesity ◽  
Japanese Population ◽  
Univariate Analysis ◽  
General Japanese Population ◽  
Increased Risk ◽  
Near Future ◽  
New Onset

Abstract Background The number of incidences of atrial fibrillation (AF) is expected to rise rapidly in the near future because of the increased number of geriatric patients in Japanese society. In addition, obesity is increasing in the general Japanese population. Although a higher body mass index is associated with a higher risk of AF, the relationship between abdominal obesity (large waist circumference) and new-onset AF is unclear. Methods and results We performed a longitudinal retrospective observational study from January 2007 to October 2018 using the annual health checkup data. Data from 58,844 adults (29,572 males, age 54±13 years) without baseline AF, who underwent routine health checkups, were analyzed. We performed logistic regression analyses to determine the strength of the association between abdominal obesity and new-onset AF. We also examined the effect of abdominal obesity on the incidences of AF stratified by gender. During a median follow-up of 4 years, we recorded new cases of AF in 322 (0.5%) individuals. In univariate analysis, a large waist circumference was significantly associated with new-onset AF, both in males [hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.02 to 1.05, p&lt;0.001] and in females (HR 1.04, 95% CI 1.01 to 1.06, p=0.002), respectively. In multivariate analysis adjusted for clinical variables (age, hypertension, dyslipidemia, estimated glomerular filtration rate, habitual drinking and diabetes), a large waist circumference was significantly and independently associated with new-onset AF in males (HR 1.04, 95% CI 1.03 to 1.06, p&lt;0.001), but not in females (HR 1.01, 95% CI 0.99 to 1.04, p=0.269). Conclusion Abdominal obesity is independently associated with an increased risk of new-onset AF in males. This association in males might imply some sex-specific mechanisms. There might be a gender difference in the effectiveness of interventions to decrease abdominal obesity to prevent AF. Funding Acknowledgement Type of funding source: None

scholarly journals Subclinical Measures of Peripheral Atherosclerosis and the Risk of New‐Onset Atrial Fibrillation in the General Population: the Rotterdam Study

2021 ◽  
Author(s):  
Sven Geurts ◽  
Cathrine Brunborg ◽  
Grigorios Papageorgiou ◽  
M. Arfan Ikram ◽  
Maryam Kavousi
Keyword(s):  
Atrial Fibrillation ◽  
General Population ◽  
Carotid Plaque ◽  
Population Based ◽  
Rotterdam Study ◽  
Link Type ◽  
Increased Risk ◽  
Onset Atrial Fibrillation ◽  
New Onset

Background Limited population‐based data on the (sex‐specific) link between subclinical measures of peripheral atherosclerosis and new‐onset atrial fibrillation (AF) exist. Methods and Results Subclinical measures of peripheral atherosclerosis including carotid intima‐media thickness (cIMT), carotid plaque, and ankle‐brachial index (ABI) were assessed at baseline and follow‐up examinations. A total of 12 840 participants free of AF at baseline from the population‐based Rotterdam Study were included. Cox proportional hazards models and joint models, adjusted for cardiovascular risk factors, were used to determine the associations between baseline and longitudinal measures of cIMT, carotid plaque, and ABI with new‐onset AF. During a median follow‐up of 9.2 years, 1360 incident AF cases occurred among 12 840 participants (mean age 65.2 years, 58.3% women). Higher baseline cIMT (fully‐adjusted hazard ratio [HR], 95% CI, 1.81, 1.21–2.71; P =0.0042), presence of carotid plaque (fully‐adjusted HR, 95% CI, 1.19, 1.04–1.35; P =0.0089), lower ABI (fully‐adjusted HR, 95% CI, 1.57, 1.14–2.18; P =0.0061) and longitudinal measures of higher cIMT (fully‐adjusted HR, 95% CI, 2.14, 1.38–3.29; P =0.0021), presence of carotid plaque (fully‐adjusted HR, 95% CI, 1.61, 1.12–2.43; P =0.0112), and lower ABI (fully‐adjusted HR, 95% CI, 4.43, 1.83–10.49; P =0.0007) showed significant associations with new‐onset AF in the general population. Sex‐stratified analyses showed that the associations for cIMT, carotid plaque, and ABI were mostly prominent among women. Conclusions Baseline and longitudinal subclinical measures of peripheral atherosclerosis (carotid atherosclerosis, and lower extremity peripheral atherosclerosis) were significantly associated with an increased risk of new‐onset AF, especially among women. Registration URL: https://www.trialregister.nl , https://www.apps.who.int/trialsearch/ ; Unique identifier: NL6645/NTR6831.

2225“New-onset atrial fibrillation efter cardiac surgery is associated with increased long-term morbidity and mortality”: a population-based study from the SWEDEHEART-registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Taha ◽  
A Jeppsson ◽  
L Friberg ◽  
S Nielsen ◽  
A Ahlsson ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Population Based ◽  
Long Term Outcome ◽  
Increased Risk ◽  
Cabg Patients ◽  
Onset Atrial Fibrillation ◽  
New Onset

Abstract Background New-onset postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, but the prognostic implications are not settled. In contrast to previous reports, a recent Danish study in coronary bypass surgery (CABG) patients (Butt et al. JAMA Cardiol 2018) did not show any increased risk for thromboembolic complications in POAF patients. Purpose To compare long-term outcome in patients with vs. without POAF after CABG. Methods All CABG patients in Sweden 2005–2015 (n=38040) were included in a retrospective population-based cohort study. Data from the SWEDEHEART registry, the National Patient Registry and the National Population Registry were merged. POAF was defined as any new-onset atrial fibrillation (AF) episode up to the 30thpostoperative day. Inverse Probability Treatment Weighting (IPTW) adjusted Cox regression models were used to compare outcome variables after the first 30 postoperative days until the end of follow-up (median 5 years, range 0–10). The models were adjusted for age, gender, CHA2DS2-VASc score, co-morbidity, and medications. Results The mean age of the entire cohort was 68 years, 79% were men and 90% had a CHA2DS2-VASc score ≥2. The incidence of POAF was 28.5% (10845/38040). During follow-up POAF, patients had a significantly higher adjusted risk for all-cause mortality [Hazard Ratio (HR) 1.16 (95% CI 1.09–1.24)], ischemic stroke [HR 1.19 (1.09–1.30)], transient ischemic attack [HR 1.17 (1.03–1.33)], pulmonary embolism [HR 1.24 (1.01–1.54)], myocardial infarction [HR 1.14 (1.04–1.25)], heart failure hospitalizations [HR.1.46 (1.35–1.59)] and recurrent AF [HR 4.33 (4.09–4.65)]. Conclusions POAF was in this comparatively large study associated with increased risk for mortality and morbidity during long-term follow-up after CABG and is hence not a trivial complication.

scholarly journals 387. Markers for Mortality in COVID-19 Patients with Atrial Fibrillation or Flutter

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S262-S262
Author(s):  
Kok Hoe Chan ◽  
Bhavik Patel ◽  
Iyad Farouji ◽  
Addi Suleiman ◽  
Jihad Slim
Keyword(s):  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Prognostic Markers ◽  
Univariate Analysis ◽  
Laboratory Data ◽  
Significant Difference ◽  
New Onset

Abstract Background Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection can lead to many different cardiovascular complications, we were interested in studying prognostic markers in patients with atrial fibrillation/flutter (A. Fib/Flutter). Methods A retrospective cohort study of patients with confirmed COVID-19 and either with existing or new onset A. Fib/Flutter who were admitted to our hospital between March 15 and May 20, 2020. Demographic, outcome and laboratory data were extracted from the electronic medical record and compared between survivors and non-survivors. Univariate and multivariate logistic regression were employed to identify the prognostic markers associated with mortality in patients with A. Fib/Flutter Results The total number of confirmed COVID-19 patients during the study period was 350; 37 of them had existing or new onset A. Fib/Flutter. Twenty one (57%) expired, and 16 (43%) were discharged alive. The median age was 72 years old, ranged from 19 to 100 years old. Comorbidities were present in 33 (89%) patients, with hypertension (82%) being the most common, followed by diabetes (46%) and coronary artery disease (30%). New onset of atrial fibrillation was identified in 23 patients (70%), of whom 13 (57%) expired; 29 patients (78%) presented with atrial fibrillation with rapid ventricular response, and 2 patients (5%) with atrial flutter. Mechanical ventilation was required for 8 patients, of whom 6 expired. In univariate analysis, we found a significant difference in baseline ferritin (p=0.04), LDH (p=0.02), neutrophil-lymphocyte ratio (NLR) (p=0.05), neutrophil-monocyte ratio (NMR) (p=0.03) and platelet (p=0.015) between survivors and non-survivors. With multivariable logistic regression analysis, the only value that had an odds of survival was a low NLR (odds ratio 0.74; 95% confidence interval 0.53–0.93). Conclusion This retrospective cohort study of hospitalized patients with COVID-19 demonstrated an association of increase NLR as risk factors for death in COVID-19 patients with A. Fib/Flutter. A high NLR has been associated with increased incidence, severity and risk for stroke in atrial fibrillation patients but to our knowledge, we are first to demonstrate the utilization in mortality predictions in COVID-19 patients with A. Fib/Flutter. Disclosures Jihad Slim, MD, Abbvie (Speaker’s Bureau)Gilead (Speaker’s Bureau)Jansen (Speaker’s Bureau)Merck (Speaker’s Bureau)ViiV (Speaker’s Bureau)

Long-term impact of new-onset atrial fibrillation complicating acute myocardial infarction on heart failure: insights from the NOAFCAMI-SH registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S.L Xu ◽  
J Luo ◽  
H.Q Li ◽  
Z.Q Li ◽  
B.X Liu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Natural Science ◽  
Funding Source ◽  
Onset Atrial Fibrillation ◽  
New Onset

Abstract Background New-onset atrial fibrillation (NOAF) complicating acute myocardial infarction (AMI) has been associated with poor survival, but the clinical implication of NOAF on subsequent heart failure (HF) is still not well studied. We aimed to investigate the relationship between NOAF following AMI and HF hospitalization. Methods This retrospective cohort study was conducted between February 2014 and March 2018, using data from the New-Onset Atrial Fibrillation Complicating Acute Myocardial Infarction in ShangHai registry, where all participants did not have a documented AF history. Patients with AMI who discharged alive and had complete echocardiography and follow-up data were analyzed. The primary outcome was HF hospitalization, which was defined as a minimum of an overnight hospital stay of a participant who presented with symptoms and signs of HF or received intravenous diuretics. Results A total of 2075 patients were included, of whom 228 developed NOAF during the index AMI hospitalization. During up to 5 years of follow-up (median: 2.7 years), 205 patients (9.9%) experienced HF hospitalization and 220 patients (10.6%) died. The incidence rate of HF hospitalization among patients with NOAF was 18.4% per year compared with 2.8% per year for those with sinus rhythm. After adjustment for confounders, NOAF was significantly associated with HF hospitalization (hazard ratio [HR]: 3.14, 95% confidence interval [CI]: 2.30–4.28; p&lt;0.001). Consistent result was observed after accounting for the competing risk of all-cause death (subdistribution HR: 3.06, 95% CI: 2.18–4.30; p&lt;0.001) or performing a propensity score adjusted multivariable model (HR: 3.28, 95% CI: 2.39–4.50; p&lt;0.001). Furthermore, the risk of HF hospitalization was significantly higher in patients with persistent NOAF (HR: 5.81; 95% CI: 3.59–9.41) compared with that in those with transient NOAF (HR: 2.61; 95% CI: 1.84–3.70; p interaction = 0.008). Conclusion NOAF complicating AMI is strongly associated with an increased long-term risk of heart. Cumulative incidence of outcome Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): 1. National Natural Science Foundation of China, 2. Natural Science Foundation of Shanghai

Abstract P208: Functional Status, Rehospitalization, and Mortality Outcomes Among Acute Myocardial Infarction Patients with Prior and New-Onset Atrial Fibrillation

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Kyle P Hornsby ◽  
Kensey Gosch ◽  
Amy L Miller ◽  
Jonathan P Piccini ◽  
Renato D Lopes ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Health Status ◽  
Functional Status ◽  
Physical Function ◽  
Adverse Outcomes ◽  
Increased Risk ◽  
New Onset

Background: Little data are available regarding differences in prognosis and health status between new-onset and prior atrial fibrillation (AF) among patients with acute myocardial infarction (AMI). Methods: The TRIUMPH study enrolled 4340 AMI patients who received longitudinal follow-up including SF-12 health status assessments through 1 year post-AMI. We compared 1-year mortality, rehospitalization, and functional status according to AF type (none, prior, new) after adjusting for differences in baseline characteristics. Results: A total of 212 AMI patients (4.9%) had prior AF and 254 (5.9%) had new-onset AF. Compared with no AF, new AF was associated with older age, male sex, first MI, worse baseline physical function, home atrioventricular nodal blocker use, and worse ventricular function (c-index 0.77). Rates of 1-year mortality were 6.2%, 14.5%, and 13.0%, and 1-year rehospitalization rates were 29.1%, 44.2%, and 36.8% for no, prior, and new AF, respectively. After multivariable adjustment, neither prior nor new AF was associated with increased 1-year mortality, and only prior AF was associated with increased risk of 1-year rehospitalization (Figure). After adjusting for baseline SF-12 physical function scores, patients with prior AF had lower 1-year scores than those with no AF (40.6 vs. 43.7, p <0.003), whereas patients with new AF had similar scores (42.9 vs. 43.7, p=0.36). Conclusion: New-onset AF during AMI is associated with a number of comorbidities but, unlike prior AF, is not associated with adverse outcomes. These results raise the question of whether AF is itself a cause of or simply a marker of comorbidities leading to downstream adverse outcomes after AMI.

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