Peripheral arterial disease and atrial fibrillation and risk of stroke, heart failure hospitalization and cardiovascular death: A nationwide cohort study

被引:29
作者
Lin, Yu-Sheng [1 ,2 ,3 ]
Tung, Tao-Hsin [4 ,5 ]
Wang, Jui [6 ]
Chen, Yu-Fen [7 ,8 ,9 ]
Chen, Tien-Hsing [10 ]
Lin, Ming-Sheng [11 ]
Chi, Ching-Chi [2 ,3 ,12 ]
Chen, Mien-Cheng [13 ]
机构
[1] Chang Gung Mem Hosp, Dept Internal Med, Div Cardiol, Chiayi 61363, Taiwan
[2] Chang Gung Univ, Grad Inst Clin Med Sci, Coll Med, Taoyuan, Taiwan
[3] Chang Gung Mem Hosp, Ctr Evidence Based Med, Chiayi 61363, Taiwan
[4] Cheng Hsin Gen Hosp, Dept Med Res & Educ, Taipei, Taiwan
[5] Fu Jen Catholic Univ, Coll Med, Dept Publ Hlth, New Taipei, Taiwan
[6] Natl Taiwan Univ, Coll Publ Hlth, Inst Epidemiol & Prevent Med, Taipei 10764, Taiwan
[7] Taipei City Govt, Dept Hlth, Taipei, Taiwan
[8] Natl Yang Ming Univ, Inst Hlth & Welf Policy, Taipei 112, Taiwan
[9] Kang Ning Jr Coll Med Care & Management, Dept Nursing, Taipei, Taiwan
[10] Chang Gung Mem Hosp, Dept Internal Med, Div Cardiol, Taoyuan, Taiwan
[11] Chang Gung Mem Hosp, Dept Internal Med, Div Cardiol, Yunlin, Taiwan
[12] Chang Gung Mem Hosp, Dept Dermatol, Chiayi 61363, Taiwan
[13] Chang Gung Univ, Coll Med, Kaohsiung Chang Gung Mem Hosp, Div Cardiol,Dept Internal Med, Kaohsiung, Taiwan
关键词
Peripheral arterial disease; Atrial fibrillation; Stroke; Heart failure; Cardiovascular death; ANKLE-BRACHIAL INDEX; ISCHEMIC-STROKE; PREDICTING STROKE; HEALTH; PREVALENCE; VALIDATION; PREVENTION; OUTCOMES; ATHEROSCLEROSIS; ASSOCIATIONS;
D O I
10.1016/j.ijcard.2015.10.091
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Peripheral arterial disease (PAD) and atrial fibrillation (AF) share several comorbidities and contribute to similar cardiovascular (CV) outcomes. Only few studies have evaluated the correlation between PAD, AF, and their interaction effects on CV outcomes. Methods: We included 597,164 adults from Taiwan's National Health Insurance Research Database to conduct a cohort study to assess whether PAD was an independent risk factor of AF and vice versa. We also examined if PAD and AF increased the incident stroke, heart failure hospitalization and CV death. Results: People with PAD had a significant higher risk of incident AF than those without PAD [adjusted hazard ratio (HR): 1.29, 95% confidence interval (CI): 1.17-1.42]. Meanwhile, people with AF did not have an increased risk of incident PAD compared to those without AF (adjusted HR: 1.00, 95% CI: 0.89-1.11). Both AF and PAD increased the risk of stroke [adjusted HR being 1.29 (95% CI: 1.17-1.43) and 1.41 (95% CI: 1.35-1.47), respectively], heart failure hospitalization [adjusted HR being 1.96 (95% CI: 1.77-2.17) and 1.35 (95% CI: 1.28-1.42), respectively], and CV death [adjusted HR being 3.33 (95% CI: 2.58-4.30) and 2.08 (95% CI: 1.80-2.41), respectively]. However, we found no interaction effects of AF and PAD on these outcomes. Conclusions: PAD is an independent risk factor of incident AF but not vice versa. Both PAD and AF are independent risk factors for stroke, heart failure hospitalization, and CV death. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:204 / 211
页数:8
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