Background: The long-term risks of thromboembolism and mortality are unknown in patients who survived following atrial fibrillation (AF) newly diagnosed during critical care. Methods: Using the Korean National Health Insurance Service database, we identified 30,869 adults who survived for > 6 months following AF newly diagnosed during critical care (ICU-AF), 269,751 control subjects with non-ICU AF (AF-control), and 439,868 control subjects without AF (No-AF) from 2005 to 2013. We performed propensity score matching and compared the risks of stroke/systemic embolism and all-cause mortality. Results: The adjusted hazard ratios (HRs) for long-term stroke/systemic embolism in the patients with ICU-AF were 0.93 (95% CI, 0.88-0.98) compared with the AF-control group and 1.50 (95% CI, 1.42-1.60) compared with the No-AF group. The adjusted HRs of the ICU-AF group for long-term mortality were 1.73 (95% CI, 1.70-1.83) and 3.20 (95% CI, 3.08-3.33) compared with the AF-control and No-AF groups, respectively. The risks of stroke/systemic embolism and mortality were significantly higher in the ICU-AF group than in the No-AF group after excluding patients with AF recurrence (adjusted HR, 1.08; 95% CI, 1.01-1.17), regardless of the causes of critical care and cardiovascular or noncardiovascular surgery. Conclusions: The patients who survived following AF newly diagnosed during critical care remained at a higher risk of long-term stroke/systemic embolism and mortality than the patients without AF regardless of AF recurrence and the causes of critical care. Close follow-up and continuous anticoagulation might be needed for these patients.
Bibliographical noteFunding Information:
Financial/nonfinancial disclosures: The authors have reported to CHEST the following: G. Y. H. L. has served as a consultant for Bayer /Janssen, BMS / Pfizer , Biotronik , Medtronic , Boehringer Ingelheim , Novartis , Verseon, and Daiichi-Sankyo , and as a speaker for Bayer , BMS / Pfizer , Medtronic , Boehringer Ingelheim , and Daiichi-Sankyo; no fees were directly received personally. B. J. has served as a speaker for Bayer , BMS / Pfizer , Medtronic , and Daiichi-Sankyo , and has received research funding from Medtronic and Abbott; no fees were directly received personally. None declared (K. K., P.-S. Y., E. J., H. T. Y., T.-H. K., J.-S. U., J.-Y. K., J.-H. S., H.-N. P., M.-H. L.).
All Science Journal Classification (ASJC) codes
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine