Wu, J; Nadarajah, R; Nakao, YM; Nakao, K; Wilkinson, C; Cowan, JC; Camm, AJ; Gale, CP
(2023)
Temporal trends of cause-specific mortality after diagnosis of atrial fibrillation.
Eur Heart J, 44 (42).
pp. 4422-4431.
ISSN 1522-9645
https://doi.org/10.1093/eurheartj/ehad571
SGUL Authors: Camm, Alan John
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Abstract
BACKGROUND AND AIMS: Reports of outcomes after atrial fibrillation (AF) diagnosis are conflicting. The aim of this study was to investigate mortality and hospitalisation rates following AF diagnosis over time, by cause, and by patient features. METHODS: Individuals aged ≥16 years with a first diagnosis of AF were identified from the UK Clinical Practice Research Datalink-GOLD dataset from Jan 1, 2001 to Dec 31, 2017. The primary outcomes were all-cause and cause-specific mortality and hospitalisation at 1 year following diagnosis. Poisson regression was used to calculate rate ratios (RRs) for mortality and incidence rate ratios (IRRs) for hospitalisation and 95% confidence intervals (CIs) comparing 2001/02 and 2016/17, adjusted for age, sex, region, socioeconomic status and 18 major comorbidities. RESULTS: Of 72 412 participants, mean (SD) age was 75.6 (12.4) years and 44 762 (61.8%) had ≥3 comorbidities. All-cause mortality declined (RR 2016/17 vs 2001/02 0.72; 95% CI 0.65-0.80), with large declines for cardiovascular (RR 0.46; 95% CI 0.37-0.58) and cerebrovascular mortality (RR 0.41; 95% CI 0.29-0.60) but not for non-cardio/cerebrovascular causes of death (RR 0.91; 95% CI 0.80-1.04). By 2016/17 deaths from dementia (67, 8.0%), outstripped deaths from acute myocardial infarction, heart failure and acute stroke combined (56, 6.7%, p < 0.001). Overall hospitalisation rates increased (IRR 2016/17 vs 2001/02 1.17; 95% CI, 1.13-1.22), especially for non-cardio/cerebrovascular causes (IRR 1.42; 95% CI 1.39-1.45). Older, more deprived, and hospital-diagnosed AF patients experienced higher event rates. CONCLUSIONS: After AF diagnosis, cardio/cerebrovascular mortality and hospitalisation has declined, whilst hospitalisation for non-cardio/cerebrovascular disease has increased.
Item Type: | Article | |||||||||
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Additional Information: | © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com | |||||||||
Keywords: | Atrial Fibrillation, Electronic Health Records, Hospitalisation, Mortality, Public Health, Atrial fibrillation, Mortality, Electronic health records, Hospitalization, Public health, 1102 Cardiorespiratory Medicine and Haematology, 1103 Clinical Sciences, Cardiovascular System & Hematology | |||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) | |||||||||
Journal or Publication Title: | Eur Heart J | |||||||||
ISSN: | 1522-9645 | |||||||||
Language: | eng | |||||||||
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Publisher License: | Creative Commons: Attribution-Noncommercial 4.0 | |||||||||
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PubMed ID: | 37624589 | |||||||||
Web of Science ID: | WOS:001067957700001 | |||||||||
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URI: | https://openaccess.sgul.ac.uk/id/eprint/115805 | |||||||||
Publisher's version: | https://doi.org/10.1093/eurheartj/ehad571 |
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