{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T08:51:36Z","timestamp":1789721496491,"version":"4.0.1"},"reference-count":30,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[2015,1,27]]},"published-print":{"date-parts":[[2015,5,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To estimate the risk of atrial fibrillation (AF) and stroke and the impact of closure in patients with atrial septal defect (ASD) compared with a general population cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>All adult Danish patients (&gt;18\u2005years) diagnosed with ASD from 1977 to 2009 (N=1168) were identified through population-based registries. Using Cox regression, we compared ASD patients\u2019 risk of AF and stroke with an age-matched and gender-matched comparison cohort. We computed prevalence proportions of anticoagulation and antiarrhythmic medicine use before and after closure and described stroke-related mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Median follow-up was 9.6\u2005years (range 1\u201333\u2005years). Patients with ASD had a higher risk of first-time AF (adjusted HR 8.2; 95% CI 6.6 to 10.2) after closure than the comparison cohort, but with no difference between transcatheter and surgical closure (HR 1.5, 95% CI 0.6 to 3.5). Patients without prevalent AF had a 10-year cumulative incidence of AF of 11% (95% CI 9% to 14%) after closure compared with 2% (95% CI 1.8% to 2.5%) in the comparison cohort. Patients with ASD with prevalent AF continued to use anticoagulation medicine after closure\/diagnosis. Patients with ASD had increased risk of stroke without closure (adjusted HR 2.6; 95% CI 1.4 to 3.0) and with closure (adjusted HR 2.0; 95% CI 1.4 to 2.7). Risk of stroke after closure was related to AF (HR adjusted for AF 1.3; 95% CI 0.9 to 1.9).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Patients with ASD had a higher risk of first-time AF after closure than the comparison cohort. There was no effect of closure on the use of AF-related medicine in patients with prevalent AF.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/heartjnl-2014-306552","type":"journal-article","created":{"date-parts":[[2015,2,18]],"date-time":"2015-02-18T01:06:41Z","timestamp":1424221601000},"page":"706-711","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":136,"title":["Atrial fibrillation and stroke in adult patients with atrial septal defect and the long-term effect of closure"],"prefix":"10.1136","volume":"101","author":[{"given":"C","family":"Nyboe","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark"},{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M S","family":"Olsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J E","family":"Nielsen-Kudsk","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V E","family":"Hjortdal","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,2,17]]},"reference":[{"key":"2025101709592866000_101.9.706.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199012133232401"},{"key":"2025101709592866000_101.9.706.2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2010.204933"},{"key":"2025101709592866000_101.9.706.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.18.2370"},{"key":"2025101709592866000_101.9.706.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199903183401103"},{"key":"2025101709592866000_101.9.706.5","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.64.2.402"},{"key":"2025101709592866000_101.9.706.6","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.98.10.946"},{"key":"2025101709592866000_101.9.706.7","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90372-T"},{"key":"2025101709592866000_101.9.706.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199508243330801"},{"key":"2025101709592866000_101.9.706.9","first-page":"510","article-title":"Percutaneous closure of a secundum atrial septal defect in elderly patients","volume":"19","author":"Yalonetsky","year":"2007","journal-title":"J Invasive Cardiol"},{"key":"2025101709592866000_101.9.706.10","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezs405"},{"key":"2025101709592866000_101.9.706.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2008.02.003"},{"key":"2025101709592866000_101.9.706.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(99)00478-6"},{"key":"2025101709592866000_101.9.706.13","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-12-0550"},{"key":"2025101709592866000_101.9.706.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.05.010"},{"key":"2025101709592866000_101.9.706.15","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(83)80048-4"},{"key":"2025101709592866000_101.9.706.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.03.063"},{"key":"2025101709592866000_101.9.706.17","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810387965"},{"key":"2025101709592866000_101.9.706.18","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811401482"},{"key":"2025101709592866000_101.9.706.19","first-page":"101","article-title":"Postoperative atrial fibrillation following open cardiac surgery: predisposing factors and complications","volume":"5","author":"Hashemzadeh","year":"2013","journal-title":"J Cardiovasc Thorac Res"},{"key":"2025101709592866000_101.9.706.20","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199710000-00011"},{"key":"2025101709592866000_101.9.706.21","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810394717"},{"key":"2025101709592866000_101.9.706.22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2010.01774.x"},{"key":"2025101709592866000_101.9.706.23","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-010-1340-y"},{"key":"2025101709592866000_101.9.706.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2010.12.005"},{"key":"2025101709592866000_101.9.706.25","doi-asserted-by":"publisher","DOI":"10.2307\/2670170"},{"issue":"(Suppl 1)","key":"2025101709592866000_101.9.706.26","first-page":"33","article-title":"[Atrial septal defect in patients over 40 years-old]","volume":"55","author":"Attie","year":"2002","journal-title":"Rev Esp Cardiol"},{"key":"2025101709592866000_101.9.706.27","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2003.022475"},{"key":"2025101709592866000_101.9.706.28","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.74.3.317"},{"key":"2025101709592866000_101.9.706.29","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.29.12.2491"},{"key":"2025101709592866000_101.9.706.30","doi-asserted-by":"publisher","DOI":"10.3109\/14017431.2012.673728"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/heartjnl-2014-306552","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T16:59:37Z","timestamp":1760720377000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/heartjnl-2014-306552"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,17]]},"references-count":30,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2015,4,9]]},"published-print":{"date-parts":[[2015,5,1]]}},"alternative-id":["10.1136\/heartjnl-2014-306552"],"URL":"https:\/\/doi.org\/10.1136\/heartjnl-2014-306552","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"value":"1355-6037","type":"print"},{"value":"1468-201X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2,17]]}}}