| アブストラクト | AIMS: Causes of death remain largely unexplored in the atrial fibrillation (AF) population. We aimed to (i) thoroughly assess causes of death in patients with AF, especially those associated with sudden cardiac death (SCD) and (ii) evaluate the potential association between AF and SCD. METHODS AND RESULTS: Linked primary and secondary care United Kingdom Clinical Practice Research Datalink dataset comprising 6 529 382 individuals aged >/=18. We identified 214 222 patients with newly diagnosed AF, and an equivalent number of non-AF patients matched for age, sex and primary care practice. The underlying primary cause of death for each patient was assessed in the form of International Classification of Diseases Tenth Revision (ICD-10) codes and also as part of broader disease categories (i.e. ICD-10 chapters). FINDINGS: Over a median follow-up of 2.7 (interquartile range: 0.7-6.0) years, 124 781 (58.25%) patients with AF died. Sudden cardiac death occurred in 13 923 patients with AF [6.50% patients with AF vs. 2.01% non-AF patients; odds ratio (OR) = 3.38, 95% confidence interval (CI): 3.27-3.50, P < 0.0001], contributing to 11.05% of all AF mortality. Diseases of the circulatory system, neoplasms and respiratory diseases explained 45% of AF mortality. Sudden cardiac death occurred more frequently in males (OR = 1.87, 95% CI: 1.80-1.93, P < 0.0001), and females with AF died more often of diseases of the circulatory, respiratory, digestive, and genitourinary system and less often of neoplastic disorders. INTERPRETATION: Conditions of the circulatory system are the main driver of mortality in the AF population. Females with AF experience higher cardiovascular and respiratory mortality but die less frequently of neoplasms. The risk of SCD is higher in the AF population, occurring more frequently in males. |
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| 投稿者 | Lai, Yongtong; Yoshimura, Hiroyuki; Zakkak, Nadine; Marijon, Eloi; Chahal, Anwar; Lip, Gregory Y H; Schmidt, Floriaan; Providencia, Rui |
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| 組織名 | Institute of Health Informatics Research, University College London, 222 Euston;Road, London NW1 2DA, UK.;Institute of Epidemiology and Health Care, University College London, 1-19;Torrington Pl, London WC1E 7HB, UK.;Cancer Intelligence, Cancer Research UK, 2 Redman Place, London E20 1JQ, UK.;Division of Cardiology, European Georges Pompidou Hospital, 20 Rue Leblanc, 75015;Paris, France.;Department of Cardiovascular Medicine, Mayo Clinic, 200 First St. SW, Rochester,;MN 55905, USA.;Center for Inherited Cardiovascular Diseases, WellSpan Health, 30 Monument Rd,;York, PA 17403, USA.;Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West;Smithfield, London EC1A 7BE, UK.;Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool;John Moores University and Liverpool Heart and Chest Hospital, Thomas Drive,;Liverpool L14 3PE, UK.;Danish Center for Health Services Research, Department of Clinical Medicine,;Aalborg University, Aalborg University Hospital, Selma Lagerlofs Vej 249, 9260;Gistrup, Denmark.;Institute of Cardiovascular Science, University College London, 62 Huntley St,;London WC1E 6DD, UK.;Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam University;Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The;Netherlands. |
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