Programme no. 434-OP
Public Health
Long-term risk of atrial fibrillation after the death of a spouse: A nationwide population-based case-control study
Simon Graff1, Bo Christensen2, Morten Fenger-Grøn3, Henrik Søndergaard Pedersen4, Jakob Christensen5, Jiong Li6, Mogens Vestergaard*7
1Research Unit for General Practice,Institute of Public Health Aarhus University,Aarhus C,Denmark, 2Section for General Practice,Institute of Public Health Aarhus University,Aarhus C,Denmark, 3Research Unit for General Practice,Institute of Public Health Aarhus University,Aarhus C,Denmark, 4Research Unit for General Practice,Institute of Public Health Aarhus University,Aarhus C,Denmark, 5Department of Clinical Medicine,Aarhus University,Aarhus C,Denmark, 6Section for Epidemiology,Institute of Public Health Aarhus University,Aarhus C,Denmark, 7Research Unit for General Practice,Institute of Public Health Aarhus University,Aarhus C,Denmark
* = Presenting author
Objectives: We examined whether one of the most stressful life events, the death of a spouse, was associated with an increased risk of AF.
Background: The impact of psychological stress on the risk of atrial fibrillation [AF] remains unclear.
Results: Spousal bereavement was experienced by 33.411 cases and 323.849 controls and was associated with a transiently higher risk for AF; the risk was the highest 8-14 days after the loss of a spouse (1.99; 95% CI 1.48–2.67), thereafter it gradually declined to a level close to that for the non-bereaved one year after the loss. Overall, the OR of AF within 30-days of the bereavement was 1.37 (95% CI 1.17–1.60), but it tended to be higher among persons younger than 60 years (2.38; 95% CI 1.19-4.77), or whose spouse had a low expected mortality i.e. age-adjusted Charlson comorbidity index one months before death (1.69; 95% CI 1.30-2.19).
Material/Methods: We conducted a population-based case-control study by using nationwide health registers in Denmark. From 1995 through 2013, we identified 113.003 cases with a hospital diagnosis of AF and 1.130.030 age and sex matched controls based on risk-set sampling. We used conditional logistic regression to calculate odds ratios [ORs] with a 95% confidence interval [95% CI].
Conclusion: Spousal bereavement was followed by a transiently increased risk of AF lasting for one year. The increase was especially high if the loss of the spouse was unexpected.
Points for discussion: In a large population-based case-control study, we examined the association between spousal bereavement and the risk of new onset AF taking time since bereavement and confounders such as age, sex, comorbidity and medication into account.