| アブストラクト | BACKGROUND: The combination of peripheral arterial disease and atrial fibrillation is linked with high risk of mortality and stroke. This study aims to investigate the impact of atrial fibrillation on patients with diagnosed peripheral arterial disease. METHODS: This is a retrospective study using The Health Improvement Network database, which contains prospectively collected data from participating primary care practices. Patients with a new diagnosis of peripheral arterial disease between January 8, 1995 and January 5, 2017 were identified in the database alongside relevant demographic information, clinical history, and medications. Every patient in the dataset with peripheral arterial disease and baseline atrial fibrillation (case) was matched to a patient without atrial fibrillation (control) with similar characteristics using propensity score matching. Cox-regression analysis was performed and hazard ratios (HR) calculated for the outcomes of death, stroke, ischemic heart disease, heart failure, and major amputation. RESULTS: Prevalence of atrial fibrillation in this cohort was 10.2%. All patients with peripheral arterial disease and atrial fibrillation (n = 5685) were matched with 5685 patients without atrial fibrillation but otherwise similar characteristics. After multivariate analysis, atrial fibrillation was independently associated with mortality (HR 1.18; 95% confidence interval [CI], 1.12-1.26; P < .01), cerebrovascular events (HR 1.35; 95% CI, 1.17-1.57; P < .01), and heart failure (HR 1.87; 95% CI, 1.62-2.15; P < .01), but not with ischemic heart disease or limb loss. CONCLUSION: In peripheral arterial disease patients, atrial fibrillation is a risk factor for mortality, stroke, and heart failure. This emphasizes the need for proactive surveillance and holistic management of these patients. |
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| ジャーナル名 | The American journal of medicine |
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| Pubmed追加日 | 2021/11/19 |
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| 投稿者 | Vitalis, Antonios; Nirantharakumar, Krishnarajah; Thayakaran, Rasiah; Vohra, Rajiv K; Kay, Mark; Shantsila, Alena; Lip, Gregory Y H |
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| 組織名 | Institute of Applied Health Research, University of Birmingham, UK; Department of;Vascular Surgery, University Hospitals Birmingham NHS Foundation Trust, Queen;Elizabeth Hospital Birmingham, UK; Liverpool Centre for Cardiovascular Science,;University of Liverpool and Liverpool Heart & Chest Hospital, UK.;Institute of Applied Health Research, University of Birmingham, UK.;Department of Vascular Surgery, University Hospitals Birmingham NHS Foundation;Trust, Queen Elizabeth Hospital Birmingham, UK.;Liverpool Centre for Cardiovascular Science, University of Liverpool and;Liverpool Heart & Chest Hospital, UK. Electronic address:;s.shantsila@liverpool.ac.uk.;Liverpool Heart & Chest Hospital, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/34793748/ |
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