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Spinal cord injury may elevate risk for AF
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A history of spinal cord injury was associated with increased long-term risk for atrial fibrillation, according to results of a new study.
CVD is the leading cause of death in patients with chronic spinal cord injury, which is associated with autonomic dysfunction, according to the study background.
Researchers conducted a retrospective cohort study to determine whether an association exists between spinal cord injury and AF. Using the Taiwan National Health Insurance Research Database, the researchers analyzed 41,691 patients hospitalized for the first time due to spinal cord injury between 2000 and 2011. All patients were free of AF.
The researchers matched those patients 4:1 by age, sex and index year with 166,724 patients hospitalized without AF or spinal cord injury. Mean follow-up was 5.69 years in the spinal cord injury group and 6.17 years in the control group.
During the follow-up period, the incidence rates of AF were 2.7 per 1,000 person-years in the spinal cord injury group and 1.99 per 1,000 person-years in the control group (crude HR = 1.36; 95% CI, 1.24-1.48), Chun-Cheng Wang, MD, from Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, and colleagues found.
The elevated risk for AF associated with spinal cord injury remained after adjustment for age, sex and all comorbidities (adjusted HR = 1.28; 95% CI, 1.17-1.4), according to the researchers.
The association was most prominent in patients with thoracic spinal injury and those with lumbar, sacral, coccygeal spinal injury or multilevel spinal injury.
Although the spinal cord injury group had higher rates of hypertension, congestive HF, CAD and chronic obstructive pulmonary disease, even those with spinal cord injury but no comorbidities had elevated risk for AF, the researchers wrote.
“We proposed that the pathogenesis of AF in patients with chronic [spinal cord injury] involves both autonomic dysfunction and other coexisting [CV] risk factors,” Wang and colleagues concluded. – by Erik Swain
Disclosure: The researchers report no relevant financial disclosures.
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