Evidence map›Paper›PMID 36041755›Full record

ArticleBMJ open2022

Mental health conditions and use of rhythm control therapies in patients with atrial fibrillation: a nationwide cohort study.

Konsta Teppo, Jussi Jaakkola, Fausto Biancari, Olli Halminen, Jukka Putaala, Pirjo Mustonen, Jari Haukka, Miika Linna, Janne Kinnunen, Alex Luojus and 6 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04645537 (Finnish AntiCoagulation in Atrial Fibrillation), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04645537 completednot on this map

Finnish AntiCoagulation in Atrial Fibrillation (FinACAF)

TypeobservationalSponsorHelsinki University Central HospitalRan2011 to 2018Enrolled400,000ConditionsAtrial Fibrillation
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
  4. Neuropsychiatry of atrial fibrillation: dementia and beyond.Frontiers in cardiovascular medicine · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 7 institutions in 1 country.

Konsta TeppoUniversity of Turku, Turku, Finland jkitep@utu.fi.ORCID 0000-0002-4460-0994
Jussi JaakkolaUniversity of Turku, Turku, Finland.
Fausto BiancariHelsingin seudun yliopistollinen keskussairaala Sydän- ja keuhkokeskus, Helsinki, Finland.
Olli HalminenAalto University, Espoo, Finland.
Jukka PutaalaDepartment of Neurology, Helsinki University Central Hospital, Helsinki, Finland.ORCID 0000-0002-6630-6104
Pirjo MustonenHeart Center, TYKS Turun yliopistollinen keskussairaala, Turku, Finland.
Jari HaukkaUniversity of Helsinki, Helsinki, Finland.ORCID 0000-0003-1450-6208
Miika LinnaAalto University, Espoo, Finland.
Janne KinnunenDepartment of Neurology, University of Helsinki, Helsinki, Finland.
Alex LuojusUniversity of Helsinki, Helsinki, Finland.
Saga Itäinen-StrömbergUniversity of Helsinki, Helsinki, Finland.
Tero PenttiläTampere University Hospital, Tampere, Finland.
Mikko NiemiDepartment of Clinical Pharmacology, University of Helsinki, Helsinki, Finland.
Juha HartikainenDepartment of Medicine, Kuopio University Hospital, Kuopio, Finland.
Ke Juhani AiraksinenHeart Center, TYKS Turun yliopistollinen keskussairaala, Turku, Finland.ORCID 0000-0002-0193-568X
Mika LehtoHelsinki University Hospital Heart and Lung Center, Helsinki, Finland.ORCID 0000-0002-8691-5142
University of Helsinki · FIHelsinki University Hospital · FIAalto University · FITurku University Hospital · FIUniversity of Turku · FIKuopio University Hospital · FITampere University Hospital · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesMental health conditions (MHCs) have been associated with undertreatment of unrelated medical conditions, but whether patients with MHCs face disparities in receiving rhythm control therapies for atrial fibrillation (AF) is currently unknown. We assessed the hypothesis that MHCs are associated with a lower use of antiarrhythmic therapies (AATs).

designA nationwide retrospective registry-based cohort study.

settingThe Finnish AntiCoagulation in Atrial Fibrillation cohort included records on all patients with AF in Finland during 2007-2018 identified from nationwide registries covering all levels of care as well as drug purchases. MHCs of interest were diagnosed depression, bipolar disorder, anxiety disorder, schizophrenia and any MHC.

participantsWe identified 239 222 patients (mean age 72.6±13.2 years; 49.8% women) with incident AF, in whom the prevalence of any MHC was 19.9%. OUTCOMES: Primary outcome was use of any AAT, including cardioversion, catheter ablation, and fulfilled antiarrhythmic drug (AAD) prescription.

resultsLower overall use of any AAT emerged in patients with any MHC than in those without MHC (16.9% vs 22.9%, p<0.001). Any MHC, depression, bipolar disorder, anxiety disorder and schizophrenia were all associated with lower incidence of any AAT with adjusted subdistribution HRs of 0.790 (95% CI 0.771 to 0.809), 0.817 (0.796 to 0.838), 0.811 (0.789 to 0.835), 0.807 (0.785 to 0.830) and 0.795 (0.773 to 0.818), respectively. Adjusted rates of AAD, cardioversion and catheter ablation use were lower in all MHC groups compared with patients without MHC. The findings in patients with any MHC were confirmed in propensity score matching analysis.

conclusionsAmong patients with AF, a clear disparity exists in AAT use between those with and without MHCs. TRIAL REGISTRATION NUMBER: ClinicalTrials Identifier: NCT04645537; ENCePP Identifier: EUPAS29845.

Indexed as

Atrial FibrillationCatheter AblationAgedAged, 80 and overAnti-Arrhythmia AgentsCohort StudiesFemaleHumansMaleMental HealthMiddle AgedRetrospective StudiesTreatment OutcomeAnti-Arrhythmia Agentscardiac epidemiologycardiologydepression & mood disordersmental healthschizophrenia & psychotic disorders

Identifiers

PMID36041755
PMCPMC9438075
OpenAlexW4293572088

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.