Lifetime Risks, Projected Numbers, and Adverse... : Chest (original) (raw)

Original Research: Cardiovascular Disease

Lifetime Risks, Projected Numbers, and Adverse Outcomes in Asian Patients With Atrial Fibrillation

A Report From the Taiwan Nationwide AF Cohort Study

Tze-Fan Chao
Chia-Jen Liu
Ta-Chuan Tuan
Tzeng-Ji Chen
Ming-Hsiung Hsieh
Gregory Y.H. Lip
Shih-Ann Chen

Chest

153

(

)

453

466

February 2018

| DOI: 10.1016/j.chest.2017.10.001

Background

Most data on the clinical epidemiology of atrial fibrillation (AF) come from Western populations, and data for Asians are limited. We investigated the lifetime risk and projected number of AF among Asians. The annual risks of adverse events among patients with AF, time trends, and the risks compared with patients without AF were analyzed.

Methods

Between 2000 and 2011, 289,559 patients aged ≥ 20 years experienced new-onset AF in Taiwan. The incidence, prevalence, and lifetime risk of AF were calculated. The risk of adverse events among patients with AF were analyzed and compared with that of age- and sex-matched patients without AF.

Results

The incidence of AF in year 2011 was 1.51 per 1,000 person-years, with a lifetime risk of AF being appropriately 1 in 7 for subjects aged > 20 years. The prevalence of AF is estimated to be 4.01% in 2050. Compared with patients without AF, AF was associated with an increased risk of mortality (adjusted hazard ratio [aHR], 2.61), heart failure (aHR, 3.31), ischemic stroke (aHR, 3.34), dementia (aHR, 1.56), sudden cardiac death (aHR, 1.83), and myocardial infarction (aHR, 1.62); all P < .01. The risks of ischemic stroke, heart failure, and mortality were especially higher compared with patients without AF in the initial period (approximately 6 months) after AF was first diagnosed.

Conclusions

The burden of AF among Asian patients is increasing, with a lifetime risk of AF being 1 in 7. Optimized management of any associated comorbidities should be part of the holistic management approach for AF.