Incident Atrial Fibrillation and Risk of Psychoactive Drug Redemptions and Psychiatric Hospital Contacts - a Danish Nationwide Register-based Follow-up Study

AIMS: To investigate wheather incident Atrial fibrillation or flutter (AF) diagnosis increases the risk of psychiatric outcomes compared to the general population.

METHODS AND RESULTS: First-time AF patients and population controls naïve to psychiatric disease or filled presciptions for psychotropic drugs were identified in Danish nationwide registries during 2005-2014. AF patients were matched 1:2 with exposure density matching. Patients and controls were compared for 1-year cumulative incidences of depression, anxiety and stress disorders, and for filled drug prescriptions for antidepressant, anxiolytic, selected antipsychotics and hypnotics. Lastly, we examined 1-year cumulative incidences of a composite endpoint of the above mentioned diagnoses or drug redemptions. We included 146,377 AF patients and 292,754 matched controls, 55% men and median age 74 (25%-75% 65-82) years. AF patients had significantly higher cumulative incidences of composite endpoints. Furthermore, filled prescriptions for anxiolytics and hypnotics were significantly higher for AF patients compared to healthy population controls. The cumulative incidence of the composite endpoint was significantly higher in AF patients relative to controls 11.1% vs. 8.3%. For the composite endpoint, a significantly higher risk was apparent both in unadjusted (HR: 2.76, 95% CI: 2.67-2.85) and adjusted (HR: 2.51, 95% CI: 2.43-2.60) models for AF patients versus controls in the first three months after study inclusion.

CONCLUSION: First-time AF patients were significantly more likely to have psychiatric outpatient or hospital contacts and to fill presciptions for psychotropic drugs compared to healthy population controls. The risk was significantly elevated only during the first three months after AF diagnosis.