Related Experiment Video

Updated: Oct 2, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

33.6K

Atrial fibrillation, liver cirrhosis, thrombosis, and bleeding: A Danish population-based cohort study

Emil B Riahi1,2, Kasper Adelborg1,3, Lars Pedersen1

  • 1Department of Clinical Epidemiology Aarhus University Hospital and Aarhus University Aarhus Denmark.

Research and Practice in Thrombosis and Haemostasis
|March 1, 2022
PubMed

Insights

Liver cirrhosis significantly increases the risk of stroke and blood clots in patients with atrial fibrillation. It also elevates the danger of various bleeding complications, underscoring the need for careful management.

Area of Science:

  • Cardiology
  • Hepatology
  • Clinical Epidemiology

Background:

  • Atrial fibrillation or flutter (AFF) is a common arrhythmia associated with thromboembolic risks.
  • Liver cirrhosis is a severe liver condition that may influence thrombotic and bleeding tendencies.
  • The interplay between liver cirrhosis and cardiovascular complications in AFF patients requires detailed investigation.

Purpose of the Study:

  • To investigate the impact of liver cirrhosis on the risk of thromboembolic events.
  • To assess the association between liver cirrhosis and bleeding complications in patients diagnosed with atrial fibrillation or flutter (AFF).

Main Methods:

  • A population-based cohort study utilizing Danish health registries from 1995 to 2016.
  • Identification of patients with a first-time diagnosis of AFF, categorized by the presence or absence of liver cirrhosis.
  • Cox regression analyses were performed to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for key clinical factors.

Main Results:

  • Patients with liver cirrhosis (0.54% of 273,225 AFF patients) exhibited higher risks of ischemic stroke (HR 1.3) and venous thromboembolism (HR 1.5).
  • A significantly elevated risk of multiple bleeding complications was observed in cirrhotic patients, including hemorrhagic stroke (HR 1.7), subdural hemorrhage (HR 3.2), and gastrointestinal hemorrhage (HR 3.3).
  • No significant difference in myocardial infarction risk was found between patients with and without liver cirrhosis.

Conclusions:

  • Liver cirrhosis is independently associated with an increased risk of ischemic stroke and venous thromboembolism in patients with AFF.
  • Patients with AFF and liver cirrhosis face a substantially elevated risk for all evaluated bleeding complications.
  • These findings highlight the complex risk profile of AFF patients with coexisting liver cirrhosis, necessitating tailored clinical management strategies.
Abstract

Keywords:
atrial fibrillationcohort studyhemorrhagic strokeischemic strokeliver cirrhosisvenous thromboembolism

More Related Videos

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

83.9K
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

1.8K

Related Concept Videos

Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
968
Disorders of Hemostasis01:24

Disorders of Hemostasis

Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
1.3K
Venous Thrombosis I: Introduction01:30

Venous Thrombosis I: Introduction

Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
56
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
42
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.4K
Venous Thrombosis IV: Nursing Management01:30

Venous Thrombosis IV: Nursing Management

Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
42