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Thromboembolic Risk in Patients With Pneumonia and New-Onset Atrial Fibrillation Not Receiving Anticoagulation
Mette Søgaard1,2, Flemming Skjøth2,3, Peter B Nielsen1,2
1Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
JAMA Network Open
|May 26, 2022
Summary
New-onset atrial fibrillation (AF) following pneumonia increases thromboembolism risk, potentially requiring anticoagulation. This condition is often persistent, not transient, impacting long-term outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Epidemiology
Background:
- New-onset atrial fibrillation (AF) is frequently observed in patients with severe infections.
- The precise risk of thromboembolic events in these patients without anticoagulation is not well-established.
Purpose of the Study:
- To evaluate thromboembolic risks linked to AF in pneumonia patients.
- To assess the likelihood of recurrent AF.
- To examine the impact of initiating anticoagulation therapy on new-onset AF.
Main Methods:
- Population-based cohort study utilizing Danish nationwide registries.
- Inclusion of patients hospitalized with community-acquired pneumonia (1998-2018).
- Statistical analysis focused on thromboembolic events, recurrent AF, and all-cause mortality, with inverse probability of censoring weights used.
Main Results:
- Among 274,196 pneumonia patients, 6,553 developed new-onset AF.
- The 1-year thromboembolism risk was 2.1% in new-onset AF patients without anticoagulation, increasing with stroke risk.
- Three-year risks ranged from 3.5% to 5.3% based on stroke risk. Recurrent AF contact occurred in 32.9%, and anticoagulation initiation in 14.0% of AF patients.
Conclusions:
- New-onset AF post-pneumonia is linked to elevated thromboembolism risk, suggesting a need for anticoagulation.
- The high rate of recurrent AF contacts indicates it's often a persistent condition, not merely transient.
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