Atrial fibrillation and future risk of venous thromboembolism: The Tromsø study

Journal article


Enga, Kristin F., Rye-Holmboe, I., Hald, Erin M., Løchen, Maja-Lisa, Mathiesen, E. B., Njølstad, I., Wilsgaard, Tom, Braekkan, S. K. and Hansen, John-Bjarne. (2015) Atrial fibrillation and future risk of venous thromboembolism: The Tromsø study. Journal of Thrombosis and Haemostasis. 13(1), pp. 10 - 16. https://doi.org/10.1111/jth.12762
AuthorsEnga, Kristin F., Rye-Holmboe, I., Hald, Erin M., Løchen, Maja-Lisa, Mathiesen, E. B., Njølstad, I., Wilsgaard, Tom, Braekkan, S. K. and Hansen, John-Bjarne
Abstract

Aims: Whether atrial fibrillation is related to risk of venous thromboembolism (VTE) has not been extensively studied. Therefore, we investigated the association between atrial fibrillation and future risk of VTE in a population-based cohort. Methods: In total, 29 975 subjects were recruited from three surveys of the Tromsø study and followed from enrollment (1994–1995, 2001–2002 and 2007–2008) up to 2010. Incident events of atrial fibrillation and VTE during follow-up were recorded. Information on potential confounders was obtained at baseline. Cox-regression models with atrial fibrillation as time-dependent variable were used to calculate hazard ratios (HRs) for VTE with 95% confidence intervals (CIs). Results: During 16 years of median follow-up, 1604 subjects were diagnosed with atrial fibrillation and 614 with incident VTE. The risk of VTE was substantially increased during the first 6 months after diagnosis of atrial fibrillation (HR, 8.44; 95% CI, 5.61–12.69), and remained increased throughout the study period (HR, 1.43; 95% CI, 1.43–1.99) compared with those without atrial fibrillation. Atrial fibrillation displayed higher risk estimates for pulmonary embolism (HR, 11.84; 95% CI, 6.80–20.63) than for deep vein thrombosis (HR, 6.20; 95% CI, 3.37–11.39) during the first 6 months, and was still associated with pulmonary embolism (HR, 1.96; 95% CI, 1.24–3.10) but not with deep vein thrombosis (HR, 1.08; 95% CI, 0.66–1.75) more than 6 months after diagnosis. Conclusion: Atrial fibrillation was associated with increased risk of VTE, and pulmonary embolism in particular. Our findings support the concept that isolated pulmonary embolism may originate from right atrial thrombi due to atrial fibrillation.

Keywordsatrial fibrillation; cohort studies; deep vein thrombosis; pulmonary embolism; risk factors
Year2015
JournalJournal of Thrombosis and Haemostasis
Journal citation13 (1), pp. 10 - 16
PublisherWiley-Blackwell Publishing Ltd.
ISSN1538-7836
Digital Object Identifier (DOI)https://doi.org/10.1111/jth.12762
Scopus EID2-s2.0-84920937956
Page range10 - 16
Research GroupMary MacKillop Institute for Health Research
Publisher's version
File Access Level
Controlled
Place of publicationUnited Kingdom
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