TY - JOUR
T1 - Mental health conditions and bleeding events in patients with incident atrial fibrillation: A Finnish nationwide cohort study
AU - Teppo, Konsta
AU - Jaakkola, Jussi
AU - Biancari, Fausto
AU - Halminen, Olli
AU - Linna, Miika
AU - Putaala, Jukka
AU - Mustonen, Pirjo
AU - Kinnunen, Janne
AU - Jolkkonen, Santeri
AU - Niemi, Mikko
AU - Hartikainen, Juha
AU - Airaksinen, K. E.Juhani
AU - Lehto, Mika
N1 - Funding Information:
This work was supported by the Aarne Koskelo Foundation , The Finnish Foundation for Cardiovascular Research , and Helsinki and Uusimaa Hospital District research fund.
Funding Information:
Konsta Teppo: none. Jussi Jaakkola: none. Fausto Biancari: none Olli Halminen: none. Jukka Putaala: Dr. Putaala reports personal fees from Boehringer-Ingelheim, personal fees and other from Bayer, grants and personal fees from BMS-Pfizer, personal fees from Portola, other from Amgen, personal fees from Herantis Pharma, personal fees from Terve Media, other from Vital Signum, personal fees from Abbott, outside the submitted work. Pirjo Mustonen: Consultant: Roche, BMS-Pfizer-alliance, Novartis Finland, Boehringer Ingelheim, MSD Finland. Miika Linna: Speaker: BMSPfizer-alliance, Bayer, Boehringer-Ingelheim. Juha Hartikainen: Research grants: The Finnish Foundation for Cardiovascular Research, EU Horizon 2020, EU FP7. Advisory Board Member: BMS-Pfizer-alliance, Novo Nordisk, Amgen. Speaker: Cardiome, Bayer. K.E. Juhani Airaksinen: Research grants: The Finnish Foundation for Cardiovascular Research; Speaker: Bayer, Pfizer and Boehringer-Ingelheim. Member in the advisory boards: Bayer, Pfizer and AstraZeneca. Mika Lehto: Consultant: BMS-Pfizer-alliance, Bayer, Boehringer-Ingelheim, and MSD; Speaker: BMS-Pfizer-alliance, Bayer, Boehringer Ingelheim, MSD, Terve Media and Orion Pharma. Research grants: Aarne Koskelo Foundation, The Finnish Foundation for Cardiovascular Research, and Helsinki and Uusimaa Hospital District research fund, Boehringer-Ingelheim.
Publisher Copyright:
© 2022
PY - 2022/9/1
Y1 - 2022/9/1
N2 - Objective: We assessed the hypothesis that mental health conditions (MHCs) are associated with higher risk of bleeding in patients with atrial fibrillation (AF). Methods: 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. Results: 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. Conclusions: MHCs are associated with a higher risk of bleeding in patients with AF.
AB - Objective: We assessed the hypothesis that mental health conditions (MHCs) are associated with higher risk of bleeding in patients with atrial fibrillation (AF). Methods: 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. Results: 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. Conclusions: MHCs are associated with a higher risk of bleeding in patients with AF.
KW - Adverse outcomes
KW - Atrial fibrillation
KW - Bleeding risk
KW - Depression, psychiatric disorders
KW - Mental health conditions
UR - http://www.scopus.com/inward/record.url?scp=85137109334&partnerID=8YFLogxK
U2 - 10.1016/j.genhosppsych.2022.08.003
DO - 10.1016/j.genhosppsych.2022.08.003
M3 - Article
AN - SCOPUS:85137109334
SN - 0163-8343
VL - 78
SP - 117
EP - 122
JO - General Hospital Psychiatry
JF - General Hospital Psychiatry
ER -
