Suicide attempt in patients with atrial fibrillation - A nationwide cohort study

Background and aims: We analyzed the incidence of suicide attempt in a Taiwanese population following admission to hospital between 2000 and 2010 for atrial fibrillation (AF). Methods: Using the National Health Insurance Research Database in Taiwan, the study cohort and the comparison cohort were 1-fold matched according to propensity score method. Cox proportion hazard regression models were used to examine the effect of AF on the risk of suicide attempt, and were shown as hazard ratios (HRs) and 95% confidence intervals (CIs). Mortality for patients who have made suicide attempts was subsequently compared between the AF and the non-AF cohorts. Results: The study included a cohort of 88,259 patients with AF and a non-AF cohort of 88,259 subjects. The overall incidence of suicide attempt for the AF and the non-AF cohorts were 5.75 and 3.97 per 10,000 person-years, respectively. AF patients were associated with an increased risk of suicide attempt compared with the non-AF controls [adjusted HR (aHR) = 1.47, 95% CI = 1.19-1.81] after controlling for the confounders. The incidence of mortality among patients who have made suicide attempts was not significantly higher in the AF cohort than in the non-AF cohort, with an adjusted HR of 1.11 (95% CI = 0.75-1.65). Conclusions: We concluded that in this large database AF patients were related with higher incidence of suicide attempt.