Red Cell Distribution Width and Risk of Atrial Fibrillation and Subsequent Thromboembolism: The Tromsø Study

Erin M. Hald; Maja-Lisa Løchen; Jostein Lappegård; Trygve S. Ellingsen; Ellisiv B. Mathiesen; Tom Wilsgaard; Inger Njølstad; Sigrid K. Brækkan; John-Bjarne Hansen

doi:10.1055/s-0040-1716417

TH Open, Inhaltsverzeichnis

CC BY 4.0 · TH Open 2020; 04(03): e280-e287
DOI: 10.1055/s-0040-1716417

Original Article

Red Cell Distribution Width and Risk of Atrial Fibrillation and Subsequent Thromboembolism: The Tromsø Study

Erin M. Hald

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

²Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.

,

Maja-Lisa Løchen

³Epidemiology of Chronic Diseases Research Group, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.

,

Jostein Lappegård

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

,

Trygve S. Ellingsen

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

,

Ellisiv B. Mathiesen

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

⁴Brain and Circulation Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.

,

Tom Wilsgaard

³Epidemiology of Chronic Diseases Research Group, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.

,

Inger Njølstad

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

³Epidemiology of Chronic Diseases Research Group, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.

,

Sigrid K. Brækkan

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

²Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.

,

John-Bjarne Hansen

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

²Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.

› Institutsangaben

Abstract

Introduction Red cell distribution width (RDW) is associated with cardiovascular diseases, including atrial fibrillation (AF) and venous thromboembolism (VTE). Whether RDW is a risk marker for thromboembolic events in AF patients is scarcely known. We aimed to assess the association between RDW and the risk of AF, and AF-related VTE and ischemic stroke, in a population-based cohort.

Methods We measured RDW in 26,111 participants from the Tromsø Study (1994–1995), and registered incident AF cases through December 31, 2013. Among participants with AF, first-ever VTEs and ischemic strokes were registered from the date of AF diagnosis through the end of follow-up. We calculated hazard ratios (HRs) with 95% confidence intervals (CIs) for AF by quartiles of RDW. Furthermore, we calculated cause-specific HRs for VTE and ischemic stroke by tertiles of RDW for participants with AF.

Results There were 2,081 incident AF cases during a median of 18.8 years of follow-up. Subjects with RDW in the highest quartile (RDW ≥ 13.3%) had 30% higher risk of AF than those in the lowest quartile (RDW ≤ 12.3%). Among those with AF, subjects with RDW in the upper tertile had a doubled risk of ischemic stroke (HR 2.07, 95% CI 1.20–3.57). In contrast, RDW was not associated with incident VTE in subjects with AF.

Conclusion RDW was significantly associated with incident AF in a general population. Among subjects with AF, high RDW was associated with ischemic stroke, but not VTE.

Keywords

venous thrombosis - arterial thrombosis - epidemiological studies - red cell distribution width

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Referenzen

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