内科学
心房颤动
医学
萧条(经济学)
焦虑
危险系数
精神分裂症(面向对象编程)
双相情感障碍
队列
队列研究
上消化道出血
精神科
儿科
置信区间
锂(药物)
宏观经济学
经济
内窥镜检查
作者
Konsta Teppo,Jussi Jaakkola,Fausto Biancari,Olli Halminen,Miika Linna,Jukka Putaala,Pirjo Mustonen,Janne Kinnunen,Santeri Jolkkonen,Mikko Niemi,Juha Hartikainen,Juhani Airaksinen,Mika Lehto
标识
DOI:10.1016/j.genhosppsych.2022.08.003
摘要
We assessed the hypothesis that mental health conditions (MHCs) are associated with higher risk of bleeding in patients with atrial fibrillation (AF).The registry-based FinACAF study covers all patients with AF diagnosed during 2007-2018 in Finland. MHCs of interest were depression, bipolar disorder, anxiety disorder, schizophrenia, and any MHC. The outcomes were first-ever gastrointestinal, intracranial, and any bleeding event.We identified 205,019 patients (50.9% female; mean age 72.3 [standard deviation 13.4] years) with incident AF without prior bleeding, and the prevalence of any MHC was 6.1%. Any MHC, depression, and anxiety disorder were associated with the risk of any bleeding (adjusted hazard ratios (HRs) 1.19 [1.12-1.27], 1.21 [1.13-1.30], and 1.21 [1.08-1.35], respectively). Additionally, any MHC and depression were associated with the risk of gastrointestinal and intracranial bleeding and anxiety disorder with gastrointestinal bleeding. Bipolar disorder and schizophrenia were not associated with risk of bleeding. Use of oral anticoagulants was associated with the risk of any bleeding (adjusted HR 1.24 [95% CI 1.21-1.28)]), and this association was similar in patients with and without MHCs. Serotonin reuptake inhibitors were not associated with bleeding risk.MHCs are associated with a higher risk of bleeding in patients with AF.
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