| アブストラクト | BACKGROUND: Atrial fibrillation (AF) confers a major healthcare burden from hospitalisations and AF-related complications, such as stroke and heart failure. We performed an electronic health records-wide association study to identify the most frequent reasons for healthcare utilization, pre and post new-onset AF. METHODS: Prospective cohort study with the linked electronic health records of 5.6 million patients in the United Kingdom Clinical Practice Research Datalink (1998-2016). A cohort study with AF patients and their age-and sex matched controls was implemented to compare the top 100 reasons of frequent hospitalisation and primary consultation. RESULTS: Of the 199,433 patients who developed AF, we found the most frequent healthcare interactions to be cardiac, cerebrovascular and peripheral-vascular conditions, both prior to AF diagnosis (41/100 conditions in secondary care, such as cerebral infarction and valve diseases; and 33/100 conditions in primary care), and subsequently (47/100 conditions hospital care and 48 conditions in primary care). There was a high representation of repeated visits for cancer and infection affecting multiple organ systems. We identified 10 novel conditions which have not yet been associated with AF: folic acid deficiency, pancytopenia, idiopathic thrombocytopenic purpura, seborrheic dermatitis, lymphoedema, angioedema, laryngopharyngeal reflux, rib fracture, haemorrhagic gastritis, inflammatory polyneuropathies. CONCLUSION: Our nationwide data provide knowledge and better understanding of the clinical needs of AF patients suggesting: (i) groups at higher risk of AF, where screening may be more cost-effective, and (ii) potential complications developing following new-onset AF that can be prevented through implementation of comprehensive integrated care management and more personalised, tailored treatment. CLINICAL TRIAL REGISTRATION: NCT04786366. |
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| ジャーナル名 | Frontiers in cardiovascular medicine |
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| 投稿日 | 2023/10/16 |
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| 投稿者 | Chung, Sheng-Chia; Schmit, Amand F; Lip, Gregory Y H; Providencia, Rui |
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| 組織名 | Institute of Health Informatics, University College London, London, United;Kingdom.;Institute of Cardiovascular Science, University College London, London, United;Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool;John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United;Danish Center for Health Services Research, Department of Clinical Medicine,;Aalborg University, Aalborg, Denmark.;Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37840952/ |
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