RT Journal Article
T1 Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism.
A1 Bikdeli, Behnood
A1 Jiménez, David
A1 Del Toro, Jorge
A1 Piazza, Gregory
A1 Rivas, Agustina
A1 Fernández-Reyes, José Luis
A1 Sampériz, Ángel
A1 Otero, Remedios
A1 Suriñach, José María
A1 Siniscalchi, Carmine
A1 Martín-Guerra, Javier Miguel
A1 Castro, Joaquín
A1 Muriel, Alfonso
A1 Lip, Gregory Y H
A1 Goldhaber, Samuel Z
A1 Monreal, Manuel
A1 RIETE Investigators †, 
K1 atrial fibrillation
K1 mortality
K1 outcome
K1 pulmonary embolism
AB Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.
YR 2021
FD 2021-08-28
LK http://hdl.handle.net/10668/18481
UL http://hdl.handle.net/10668/18481
LA en
DS RISalud
RD Apr 18, 2025