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VTE raises risk for future AF
Incident venous thromboembolism was associated with future risk for atrial fibrillation in a prospective, population-based study.
Researchers investigated the effect of incident VTE on future AF risk using data from 29,974 participants of the Tromsø study surveys conducted between 1994-1995, 2001-2002 and 2007-2008. All responders were aged at least 25 years and resided in Tromsø, Norway. The participants had physical examinations, provided nonfasting blood samples, and responded to self-administered questionnaires assessing history of CVD, diabetes and smoking status.
Incident VTE occurred in 1.8% of participants during a median follow-up of 15.7 years. Among those, 9.3% subsequently developed AF. AF in the absence of VTE was diagnosed in 5.54% of participants.
Multivariate analysis indicated a higher risk for AF among participants with VTE compared with those without VTE (adjusted HR=1.63; 95% CI, 1.22-2.17). Risk for AF was also more pronounced among patients who had pulmonary embolism (HR=1.78; 95% CI, 1.13-2.8) or deep vein thrombosis (HR=1.51; 95% CI, 1.05-2.18).
Participants were at even higher risk for subsequent AF within the first 6 months after a VTE event (HR=4; 95% CI, 2.21-7.25). This risk increase declined during the first year post-diagnosis, but remained statistically significant for 3 years after the event.
Further analysis stratified according to age indicated increased risk for AF after a VTE event among participants younger than 65 years (HR=1.95; 95% CI, 0.81-4.73). Risk was less pronounced among those older than 65 years (HR=1.83; 95% CI, 1.36-2.46).
“To the best of our knowledge, the present study is the first cohort study to show that VTE is associated with subsequent risk of atrial fibrillation in the general population,” the researchers wrote. “Our findings support the concept that right ventricular pressure overload causes persistent right-sided ventricular dysfunction and strain, resulting in atrial stretch and subsequent fibrillation.” The researchers added that, as this was an observational study, they are unable to draw conclusions on the pathophysiology of these findings.
Disclosure: The researchers report no relevant financial disclosures.