1. Long-term risk of atrial fibrillation after the death of a partner
- Author
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Bo Christensen, Mogens Vestergaard, Simon Graff, Jiong Li, Jakob Christensen, Morten Fenger-Grøn, and Henrik Pedersen
- Subjects
medicine.medical_specialty ,education.field_of_study ,business.industry ,Population ,Atrial fibrillation ,medicine.disease_cause ,medicine.disease ,Long term risk ,Increased risk ,Charlson comorbidity index ,Internal medicine ,medicine ,Cardiology ,Psychological stress ,Conditional logistic regression ,Myocardial infarction ,Arrhythmias and Sudden Death ,Cardiology and Cardiovascular Medicine ,business ,education - Abstract
Dette studie viser, at mennesker, som for nylig har mistet deres partner, har en øget risiko for at udvikle uregelmæssig hjerterytme i op til ét år efter tabet. Den øgede risiko forekommer i op til et år efter tabet, og den største risiko ses hos efterladte på under 60 år og ved uventede dødsfald. Perioden mellem 8 og 14 dage efter dødsfaldet ser ud til at udgøre den største risiko, hvorefter den gradvist falder til et normalt leje et år efter eksponeringen. Resultaterne tyder på, at akut opstået stress muligvis forstyrrer den naturlige hormonbalance og påvirker en ellers normal hjerterytme. Det nye studie bekræfter, at der er en sammenhæng mellem vores mentale tilstand og det fysiske helbred. Det er uvist, hvilke mekanismer der er på spil, men mange med atrieflimren nævner stress som en udløsende faktor. I klinisk praksis kan en større opmærksomhed mod den efterladtes psykiske tilstand i tiden efter tabet hjælpe med at forebygge hjertearytmi, før det udvikler sig kritisk. Objectives: Severe psychological stress is generally associated with an increased risk of acute cardiovascular diseases, such as myocardial infarction, but it remains unknown whether it also applies to atrial fibrillation. We conducted a population-based case–control study using nationwide Danish health registers to examine the risk of atrial fibrillation after the death of a partner.Methods: From 1995 through 2014, we identified 88 612 cases with a hospital diagnosis of atrial fibrillation and 886 120 age-matched and sex-matched controls based on risk-set sampling. The conditional logistic regression model was used to calculate adjusted ORs of atrial fibrillation with 95% CIs.Results: Partner bereavement was experienced by 17 478 cases and 168 940 controls and was associated with a transiently higher risk of atrial fibrillation; the risk was highest 8–14 days after the loss (1.90; 95% CI 1.34 to 2.69), after which it gradually declined. One year after the loss, the risk was almost the same as in the non-bereaved population. Overall, the OR of atrial fibrillation within 30 days after bereavement was 1.41 (95% CI 1.17 to 1.70), but it tended to be higher in persons below the age of 60 years (2.34; 95% CI 1.02 to 5.40) and in persons whose partner had a low predicted mortality 1 month before the death, that is, ≤5 points on the age-adjusted Charlson Comorbidity Index (1.57; 95% CI 1.13 to 2.17).Conclusions: The severely stressful life event of losing a partner was followed by a transiently increased risk of atrial fibrillation lasting for 1 year, especially for the least predicted losses.
- Published
- 2016
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