These authors contributed equally to this study.
Is atrial fibrillation associated with pulmonary embolism?
Version of Record online: 29 FEB 2012
© 2011 International Society on Thrombosis and Haemostasis
Journal of Thrombosis and Haemostasis
Volume 10, Issue 3, pages 347–351, March 2012
How to Cite
GEX, G., GERSTEL, E., RIGHINI, M., LE GAL, G., AUJESKY, D., ROY, P.-M., SANCHEZ, O., VERSCHUREN, F., RUTSCHMANN, O. T., PERNEGER, T. and PERRIER, A. (2012), Is atrial fibrillation associated with pulmonary embolism?. Journal of Thrombosis and Haemostasis, 10: 347–351. doi: 10.1111/j.1538-7836.2011.04608.x
- Issue online: 29 FEB 2012
- Version of Record online: 29 FEB 2012
- Accepted manuscript online: 28 DEC 2011 12:00AM EST
- Received 7 October 2011, accepted 19 December 2011
- atrial fibrillation;
- pulmonary embolism
Summary. Background: A pulmonary embolism (PE) is thought to be associated with atrial fibrillation (AF). Nevertheless, this association is based on weak data. Objectives: To assess whether the presence of AF influences the clinical probability of PE in a cohort of patients with suspected PE and to confirm the association between PE and AF. Patients/methods: We retrospectively analyzed the data from two trials that included 2449 consecutive patients admitted for a clinically suspected PE. An electrocardiography (ECG) was systematically performed and a PE was diagnosed by computer tomography (CT). The prevalence of AF among patients with or without a PE was compared in a multivariate logistic regression model. Results: The prevalence of PE was 22.8% (519/2272) in patients without AF and 18.8% (25/133) in patients with AF (P = 0.28). After adjustment for confounding factors, AF did not significantly modify the probability of PE (odds ratio [OR] 0.68, 95% confidence interval [CI] 0.42–1.11). However, when PE suspicion was based on new-onset dyspnea, AF significantly decreased the probability of PE (OR 0.47, 95% CI 0.26–0.84). If isolated chest pain without dyspnea was the presenting complaint, AF tended to increase the probability of PE (OR 2.42, 95% CI 0.97–6.07). Conclusions: Overall, the presence of AF does not increase the probability of PE when this diagnosis is suspected. Nevertheless, when PE suspicion is based on new-onset dyspnea, AF significantly decreases the probability of PE, as AF may mimic its clinical presentation. However, in patients with chest pain alone, AF tends to increase PE probability.