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30-year nationwide trends in incidence of atrial fibrillation in Denmark and associated 5-year risk of heart failure, stroke, and death.

https://arctichealth.org/en/permalink/ahliterature286741
Source
Int J Cardiol. 2016 Dec 15;225:30-36
Publication Type
Article
Date
Dec-15-2016
Author
Morten Schmidt
Sinna Pilgaard Ulrichsen
Lars Pedersen
Hans Erik Bøtker
Jens Cosedis Nielsen
Henrik Toft Sørensen
Source
Int J Cardiol. 2016 Dec 15;225:30-36
Date
Dec-15-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Atrial Fibrillation - epidemiology - mortality - therapy
Cohort Studies
Death
Denmark - epidemiology
Female
Follow-Up Studies
Heart Failure - epidemiology - mortality - therapy
Hospitalization - trends
Humans
Incidence
Male
Middle Aged
Population Surveillance - methods
Registries
Risk factors
Stroke - epidemiology - mortality - therapy
Time Factors
Abstract
Long-term nationwide trends in atrial fibrillation (AF) incidence and 5-year outcomes are rare.
We conducted a population-based cohort study using the Danish National Patient Registry covering all Danish hospitals. We computed standardized incidence rates during 1983-2012. We used Cox regression to estimate hazard ratios (HRs) of heart failure, stroke, and death within 5years, comparing 5-year calendar periods with the earliest period (1983-1987) as reference.
We identified 312,420 patients with first-time hospital-diagnosed AF. The incidence rate per 100,000person-years increased from 98 in 1983 to 307 in 2012. The mean annual increase during the 30-year study period was 4%, with a 6% increase annually until 2000 and a 1.4% increase annually thereafter. The incidence trends were most pronounced among men and persons above 70years. Among high-risk subgroups, AF incidence was consistently highest in patients with valvular heart disease or heart failure. The rate of heart failure following AF declined by 50% over the entire study period (HR: 0.49, 95% confidence interval (CI): 0.48-0.51) and the mortality rate declined by 40% (HR: 0.62, 95% CI: 0.61-0.63). Within the last two decades, the rate for ischemic stroke declined by 20% (HR 0.81, 95% CI: 0.78-0.84), but increased almost as much for haemorrhagic stroke (HR: 1.14, 95% CI: 1.01-1.29).
The long-term risk of heart failure, ischemic stroke, and death following onset of AF has decreased remarkably over the last three decades. Still, the threefold increased incidence of hospital-diagnosed AF during the same period is a major public health concern.
PubMed ID
27705839 View in PubMed
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