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Incident Thromboembolism in the Aorta and the Renal, Mesenteric, Pelvic, and Extremity Arteries After Discharge From the Hospital With a Diagnosis of Atrial Fibrillation
Lars Frost, MD, PhD;
Gerda Engholm, MS;
Søren Johnsen, MD;
Henrik Møller, MS;
Eskild W. Henneberg, MD;
Steen Husted, MD, PhD
Arch Intern Med. 2001;161:272-276.
Background The impact of atrial fibrillation (AF) on risk of peripheral arterial
thromboembolism is unknown.
Methods We analyzed the risk of thromboembolism (embolus and/or thrombosis)
in the aorta and the renal, mesenteric, pelvic, and extremity arteries in
a cohort of patients discharged from the hospital with an incident diagnosis
of AF relative to the risk of thromboembolism in these vessels in the Danish
population. In a random sample of half of the Danish population, 14 917
men and 14 945 women aged 50 to 89 years were identified in the Danish
National Hospital Discharge Register with a diagnosis of AF from January 1,
1980, through December 31, 1993. Patients were followed up from diagnosis
of AF in the Danish National Hospital Discharge Register and the Causes of
Death Register until the first diagnosis of a thromboembolic event, death,
or the end of 1993. Risk of a thromboembolic event relative to the risk in
the Danish population was analyzed by means of Poisson regression modeling.
Results Patients with a hospital diagnosis of AF had an increased risk of thromboembolic
events in the aorta and the renal, mesenteric, pelvic, and extremity arteries
(relative risk, 4.0 [95% confidence interval, 3.5-4.6] in men; and relative
risk, 5.7 [95% confidence interval, 5.1-6.3] in women) compared with the Danish
population.
Conclusion A hospital diagnosis of AF is an important risk factor for peripheral
arterial thromboembolic complications.
From the Department of Cardiology, Amtssygehuset, Aarhus University
Hospital (Drs Frost, Johnsen, and Husted), and Department of Clinical Epidemiology,
Aarhus University Hospital and Aalborg Sygehus (Drs Frost and Johnsen), Aarhus,
Denmark; Centre for Research in Health & Social Statistics, Danish National
Research Foundation, Copenhagen (Ms Engholm and Mr Møller); and Department
of Vascular Surgery, Viborg Sygehus, Viborg, Denmark (Dr Henneberg).
Reprints: Lars Frost, MD, PhD, Department of Cardiology, Aarhus Amtssygehus,
DK-8000 Aarhus C, Denmark (e-mail: l.frost{at}dadlnet.dk).
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