Association between Anemia and New-Onset Atrial Fibrillation in Critically Ill Patients in the Intensive Care Unit: A Retrospective Cohort Analysis

New-onset atrial fibrillation (NOAF) is one of the leading causes of morbidity and mortality, especially in older patients in the intensive care unit (ICU). Although many comorbidities are associated with NOAF, the effect of anemia on the onset of atrial fibrillation is still unknown. This study aimed to test the hypothesis that anemia is associated with an increased risk of developing NOAF in critically ill patients in intensive care. We performed a retrospective analysis of critically ill patients who underwent routine hemoglobin and electrocardiography monitoring in the ICU. Receiver operating characteristics analysis determined the hemoglobin (Hb) value that triggered NOAF formation. Bivariate correlation was used to determine the relationship between anemia and NOAF. The incidence of NOAF was 9.9% in the total population, and 12.8% in the patient group with anemia. Analysis of 1931 patients revealed a negative association between anemia and the development of NOAF in the ICU. The stimulatory Hb cut-off value for the formation of NOAF was determined as 9.64 g/dL. Anemia is associated with the development of NOAF in critically ill patients in intensive care.

[1]  M. Trivella,et al.  Transfusion thresholds for guiding red blood cell transfusion. , 2021, The Cochrane database of systematic reviews.

[2]  V. Salomaa,et al.  Chronic kidney disease and risk of atrial fibrillation and heart failure in general population‐based cohorts: the BiomarCaRE project , 2021, ESC heart failure.

[3]  Congxin Huang,et al.  A narrative review of non-coding RNAs in atrial fibrillation: potential therapeutic targets and molecular mechanisms , 2021, Annals of translational medicine.

[4]  Y. Chong,et al.  Atrial fibrillation increases inpatient and 4-year all-cause mortality in critically ill patients with liver cirrhosis , 2021, Annals of translational medicine.

[5]  J. Qian,et al.  Prognosis and management of new‐onset atrial fibrillation in critically ill patients , 2021, BMC Cardiovascular Disorders.

[6]  Zetao Ma,et al.  Predictive value of red blood cell distribution width in critically ill patients with atrial fibrillation: a retrospective cohort study. , 2021, Annals of palliative medicine.

[7]  Wuyang He,et al.  A systematic review and meta-analysis of catheter ablation for atrial fibrillation. , 2021, Annals of palliative medicine.

[8]  J. Meier,et al.  RBC Transfusion Triggers: Is There Anything New? , 2020, Transfusion Medicine and Hemotherapy.

[9]  P. Nikolaidis,et al.  Atrial Fibrillation in Athletes—Features of Development, Current Approaches to the Treatment, and Prevention of Complications , 2019, International journal of environmental research and public health.

[10]  D. McAuley,et al.  Protocol for a systematic review and network meta-analysis of the management of new onset atrial fibrillation in critically unwell adult patients , 2019, Systematic Reviews.

[11]  J. Chacko,et al.  Red Blood Cell Transfusion Thresholds in Critically Ill Patients , 2019, Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine.

[12]  A. Kulkarni,et al.  Landmark Papers on Blood and Component Transfusion Therapy in the Critically Ill: A Critical Analysis , 2019, Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine.

[13]  P. Ponikowski,et al.  The clinical significance of interleukin‐6 in heart failure: results from the BIOSTAT‐CHF study , 2019, European journal of heart failure.

[14]  S. Uchino,et al.  Epidemiology, prevention, and treatment of new-onset atrial fibrillation in critically ill: a systematic review , 2015, Journal of Intensive Care.

[15]  Yenn-Jiang Lin,et al.  Inflammation and the pathogenesis of atrial fibrillation , 2015, Nature Reviews Cardiology.

[16]  O. Cremer,et al.  Incidence, risk factors and outcomes of new-onset atrial fibrillation in patients with sepsis: a systematic review , 2014, Critical Care.

[17]  P. Visintainer,et al.  Blood Transfusion and the Risk of Atrial Fibrillation after Cardiac Surgery , 2014, Journal of cardiac surgery.

[18]  B. Scherlag,et al.  Role of neural modulation in the pathophysiology of atrial fibrillation , 2014, The Indian journal of medical research.

[19]  E. Benjamin,et al.  Incident stroke and mortality associated with new-onset atrial fibrillation in patients hospitalized with severe sepsis. , 2011, JAMA.

[20]  P. Kirchhof,et al.  Pathophysiological mechanisms of atrial fibrillation: a translational appraisal. , 2011, Physiological reviews.

[21]  L. Jensen,et al.  Anemia and blood transfusion practices in the critically ill: a prospective cohort review. , 2010, Heart & lung : the journal of critical care.

[22]  D. Steensma,et al.  Anemia in the elderly: how should we define it, when does it matter, and what can be done? , 2007, Mayo Clinic proceedings.

[23]  N. Andrews,et al.  Interleukin-6 induces hepcidin expression through STAT3. , 2006, Blood.

[24]  T. Walsh,et al.  The prevalence and characteristics of anaemia at discharge home after intensive care , 2006, Intensive Care Medicine.

[25]  H Artucio,et al.  Cardiac arrhythmias in critically ill patients: Epidemiologic study , 1990, Critical care medicine.

[26]  J. Edwards,et al.  Atrial fibrillation precipitated by acute hypovolaemia. , 1987, British medical journal.

[27]  W. Shoemaker,et al.  Reliability of clinical monitoring to assess blood volume in critically ill patients. , 1982 .