scholarly journals Time-Dependent Risk of Atrial Fibrillation in Patients With Primary Aldosteronism After Medical or Surgical Treatment Initiation

Hypertension ◽  
2021 ◽  
Author(s):  
Kyoung Jin Kim ◽  
Namki Hong ◽  
Min Heui Yu ◽  
Hokyou Lee ◽  
Seunghyun Lee ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Essential Hypertension ◽  
Receptor Antagonist ◽  
Primary Aldosteronism ◽  
Mineralocorticoid Receptor ◽  
Time Dependent ◽  
Mineralocorticoid Receptor Antagonist ◽  
Increased Risk ◽  
Onset Atrial Fibrillation ◽  
New Onset

Increased risk of atrial fibrillation was reported in patients with primary aldosteronism. However, data are limited regarding the time-dependent risk of atrial fibrillation in surgically or medically treated primary aldosteronism. From the National Health Insurance Claim database in Korea (2003–2017), a total of 1418 patients with primary aldosteronism (adrenalectomy [ADX], n=755, mineralocorticoid receptor antagonist n=663) were age- and sex-matched at a 1:5 ratios to patients with essential hypertension (n=7090). Crude incidence of new onset atrial fibrillation was 2.96% in primary aldosteronism and 1.97% in essential hypertension. Because of nonproportional hazard observed in new onset atrial fibrillation, analysis time was split at 3 years. Compared with essential hypertension, risk of new onset atrial fibrillation peaked at 1 year gradually declined but remained elevated up to 3 years in overall treated primary aldosteronism (adjusted hazard ratio [aHR] 3.02; P <0.001) as well as in both ADX (aHR, 3.54; P <0.001) and mineralocorticoid receptor antagonist groups (aHR 2.27; P =0.031), which became comparable to essential hypertension afterward in both groups (ADX aHR, 0.38; P =0.102; mineralocorticoid receptor antagonist aHR, 0.60; P =0.214). Nonetheless, mineralocorticoid receptor antagonist group was associated with increased risk of nonfatal stroke (aHR, 1.21; P =0.031) compared with essential hypertension, whereas ADX was not (aHR, 1.26; P =0.288). Our results suggest the risk of new-onset atrial fibrillation remained elevated up to 3 years in treated primary aldosteronism compared with essential hypertension, which declined to comparable risk in essential hypertension thereafter. Monitoring for atrial fibrillation up to 3 years after treatment, particularly ADX, might be warranted.

scholarly journals New-Onset Atrial Fibrillation in Patients With Primary Aldosteronism Receiving Different Treatment Strategies: Systematic Review and Pooled Analysis of Three Studies

2021 ◽  
Vol 12 ◽  
Author(s):  
Cheng-Hsuan Tsai ◽  
Ya-Li Chen ◽  
Chien-Ting Pan ◽  
Yen-Tin Lin ◽  
Po-Chin Lee ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Essential Hypertension ◽  
Primary Aldosteronism ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Cochrane Library ◽  
Mineralocorticoid Receptor Antagonist ◽  
Onset Atrial Fibrillation ◽  
New Onset

BackgroundPrimary aldosteronism (PA) is a common cause of secondary hypertension and associated with higher incidence of new-onset atrial fibrillation (NOAF). However, the effects of surgical or medical therapies on preventing NOAF in PA patents remain unclear. The aim of this meta-analysis study was to assess the risk of NOAF among PA patients receiving mineralocorticoid receptor antagonist (MRA) treatment, PA patients receiving adrenalectomy, and patients with essential hypertension.MethodsWe performed the meta-analysis of the randomized or observational studies that investigated the incidence rate of NOAF in PA patients receiving MRA treatment versus PA patients receiving adrenalectomy from database inception until December 01, 2020 which were identified from PubMed, Embase, and Cochrane Library.ResultsA total of 172 related studies were reviewed, of which three fulfilled the inclusion criteria, including a total of 2,705 PA patients. The results of meta-analysis demonstrated a higher incidence of NOAF among the PA patients receiving MRA treatment compared to the PA patients receiving adrenalectomy (pooled odds ratio [OR]: 2.83, 95% confidence interval [CI]: 1.76–4.57 in the random effects model, I2 = 0%). The pooled OR for the PA patients receiving MRA treatment compared to the patients with essential hypertension was 1.91 (95% CI: 1.11–3.28). The pooled OR for the PA patients receiving adrenalectomy compared to the patients with essential hypertension was 0.70 (95% CI: 0.28–1.79).ConclusionCompared to the essential hypertension patients and the PA patients receiving adrenalectomy, the patients with PA receiving MRA treatment had a higher risk of NOAF.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42021222022.

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 The Association of New-Onset Atrial Fibrillation and Risk of Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Mengxia Zhang ◽  
Lin-ling Li ◽  
Qian-qian Zhao ◽  
Xiao-dong Peng ◽  
Kui Wu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Meta Analysis ◽  
Large Sample Size ◽  
Systematic Analysis ◽  
Incident Cancer ◽  
Increased Risk ◽  
Risk Of Cancer ◽  
The Relationship ◽  
Onset Atrial Fibrillation ◽  
New Onset

Background. There are distinct results for the relationship between new-onset atrial fibrillation (NOAF) and subsequent incident cancer. To date, no systematic analysis has been conducted on this issue. This study aims to explore the relationship between NOAF and the risk of developing cancer through a meta-analysis with a large sample size. Methods. Electronic databases, such as PubMed and EMBASE, were searched for published relevant studies on NOAF patients diagnosed with cancer after and during follow-ups, including reported records of baseline information and the statistical result of morbidity. Two investigators independently reviewed the articles and extracted the data using uniform standards and definitions. The meta-analysis was conducted using the Cochrane Program Review Manager. Results. This meta-analysis consisted of five cohort studies and one case-control study, which comprised 533,514 participants. The pooled relative risk (RR) for incident cancer was 1.24 (95% CI: 1.10–1.39, P=0.0003). The temporal trend analysis demonstrated that an increased risk of cancer was observed during the initial 90 days (RR: 3.44, 95% CI: 2.29–5.57, P<0.00001), but not after that. Lung cancer (RR: 1.51, 95% CI: 1.47–1.55, P<0.00001) was associated with NOAF, but not colorectal cancer and breast cancer. Conclusion. This meta-analysis provides evidence that NOAF is associated with increased risk of cancer. The risk of incident cancer particularly increases within 90 days after NOAF diagnosis, but not after that.

P945Abnormalities in ankle-brachial indices are independently associated with new-onset atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Tseng ◽  
M Girardo ◽  
D Atwal ◽  
C Firth ◽  
J Shipman ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Hazard Analysis ◽  
Chronic Kidney Disease Stage ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Disease Stage ◽  
Chronic Obstructive ◽  
Increased Risk ◽  
Onset Atrial Fibrillation ◽  
New Onset

Abstract Introduction Lower extremity physiologic studies are an important non-invasive diagnostic tool in peripheral arterial disease (PAD). PAD and atrial fibrillation (AF) are associated with increased cardiovascular and all-cause mortality. Purpose To evaluate the association between PAD and new-onset AF and the risk of stroke. Methods We performed a study of all patients without AF undergoing ankle-brachial index (ABI) for any indication between January 1996 to June 2018. The ABI cut-off were as follows: abnormal ABI (0–0.99), normal ABI (1.00–1.39) and poor vessel compressibility (PC) (1.40+). Demographic, comorbidity, and outcome variables were extracted using the electronic medical record. Results Overall, 34,441 patients (mean age 66.8±14.3, 57.3% male, 88.2% white) were included in the study with a median follow-up of 7.2 years (interquartile range, 3.0–12.9 years). Multivariate Cox proportional hazard analysis showed increased risk of new-onset AF for male sex, older age, hypertension, coronary artery disease, cerebrovascular disease, chronic kidney disease stage III or greater, congestive heart failure, chronic obstructive pulmonary disease, and cancer (all p<0.0001). After adjustment, ABI results were significantly associated with new-onset AF, particularly poorly-compressible vessels (adjusted HR: 1.42 (1.30–1.55), p<0.0001) compared to abnormal ABI (adjusted HR: 1.12 (1.05–1.20), p=0.0012). Patients with atrial fibrillation were more likely to experience ischemic stroke (39.2% versus 16.1%, p<0.0001). Conclusion Abnormalities in ABI results, particularly poorly-compressible vessels, are independently associated with new-onset atrial fibrillation in a large ambulatory cohort. While the mechanism cannot be assessed, common inflammatory mechanisms and increased vascular stiffness may play an important role. Identification of AF in these at-risk patients may improve cardiovascular outcomes.

Chronic Osteomyelitis Is Associated With Increased Risk of New-Onset Atrial Fibrillation: Evidence From a Nationwide Cohort of 23 Million People

2016 ◽  
Vol 32 (12) ◽  
pp. 1388-1395 ◽  
Author(s):  
Lien-Cheng Hsiao ◽  
Chih-Hsin Muo ◽  
Che-Yi Chou ◽  
Chun-Hung Tseng ◽  
Ming-Fong Chen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Osteomyelitis ◽  
Increased Risk ◽  
Onset Atrial Fibrillation ◽  
New Onset
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