Association Between Aplastic Anemia and Atrial Fibrillation: Is Inflammation the Only Underlying Mechanism?　― Reply ―

We appreciate the interest of Şener et al in our study entitled “Aplastic anemia and risk of incident atrial fibrillation: A nationwide cohort study” published in the Circulation Journal in April 2018.¹ They suggest that blood transfusion-induced inflammatory response and undetected myocardial damage are associated with incident atrial fibrillation (AF) in patients with aplastic anemia (AA). In order to verify their hypothesis, we conducted an additional data analysis and found that patients with AA receiving blood transfusion had an adjusted subhazard ratio (SHR) of 1.45 (95% confidence interval (CI)=1.01–2.09) for AF, compared with subjects without AA and blood transfusion. However, the adjusted SHR of AF was 0.92 (95% CI=0.62–1.36) when comparing with AA patients without blood transfusion. Further studies to explore the detailed mechanism underlying the association are highly encouraged.

Disclosures

None.

• Wei-Syun Hu, MD, PhD
• Fung-Chang Sung, PhD
• Cheng-Li Lin
• School of Medicine, College of Medicine (W.-S.H.),
• Department of Health Services Administration (F.-C.S.),
• China Medical University, Taichung;
• Division of Cardiovascular Medicine,
• Department of Medicine (W.-S.H.),
• Management Office for Health Data (F.-C.S., C.-L.L.),
• China Medical University Hospital, Taichung, Taiwan

Reference

• 1.   Hu WS, Sung FC, Lin CL. Aplastic anemia and risk of ıncident atrial fibrillation: A nationwide cohort study. Circ J 2018; 82: 1279–1285.