Long-term risk of atrial fibrillation after the death of a partner

Abstract

Objectives: Severe psychological stress is generally associated with an increased risk of acute cardiovascular diseases, such as myocardial infarction, but it remains unknown whether it also applies to atrial fibrillation. We conducted a population-based case-control study using nationwide Danish health registers to examine the risk of atrial fibrillation after the death of a partner. Methods: From 1995 through 2014, we identified 88,612 cases with a hospital diagnosis of atrial fibrillation and 886,120 age- and sex-matched controls based on risk-set sampling. The conditional logistic regression model was used to calculate adjusted odds ratios of atrial fibrillation with 95% confidence intervals. Results: Partner bereavement was experienced by 17,478 cases and 168,940 controls and was associated with a transiently higher risk of atrial fibrillation; the risk was highest 8-14 days after the loss (1.92; 95% CI, 1.36-2.72), after which it gradually declined. One year after the loss, the risk was almost the same as in the non-bereaved population. Overall, the OR of atrial fibrillation within 30 days after bereavement was 1.42 (95% CI, 1.19-1.71), but it tended to be higher in persons below the age of 60 years (2.36; 95% CI, 1.02-5.45) and in persons whose partner had a low expected mortality one month before the death, i.e. ≤ 5 points on the age-adjusted Charlson Comorbidity Index (1.59; 95% CI, 1.15-2.20). Conclusions: The severely stressful life event of losing a partner was followed by a transiently increased risk of atrial fibrillation lasting for one year, especially if the loss was unexpected.