| アブストラクト | BACKGROUND AND AIMS: Reports of outcomes after atrial fibrillation (AF) diagnosis are conflicting. The aim of this study was to investigate mortality and hospitalization 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 1 January 2001, to 31 December 2017. The primary outcomes were all-cause and cause-specific mortality and hospitalization at 1 year following diagnosis. Poisson regression was used to calculate rate ratios (RRs) for mortality and incidence RRs (IRRs) for hospitalization and 95% confidence intervals (CIs) comparing 2001/02 and 2016/17, adjusted for age, sex, region, socio-economic status, and 18 major comorbidities. RESULTS: Of 72 412 participants, mean (standard deviation) 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). In 2016/17, deaths caused from dementia (67, 8.0%), outstripped deaths from acute myocardial infarction, heart failure, and acute stroke combined (56, 6.7%, P < .001). Overall hospitalization 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 hospitalization has declined, whilst hospitalization for non-cardio/cerebrovascular disease has increased. |
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| ジャーナル名 | European heart journal |
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| 投稿日 | 2023/8/25 |
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| 投稿者 | Wu, Jianhua; Nadarajah, Ramesh; Nakao, Yoko M; Nakao, Kazuhiro; Wilkinson, Chris; Cowan, J Campbell; Camm, A John; Gale, Chris P |
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| 組織名 | Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary;University of London, 58 Turner Street, London E1 2AB, UK.;Leeds Institute of Data Analytics, University of Leeds, Leeds, UK.;Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds,;Leeds, UK.;Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.;Academic Cardiovascular Unit, South Tees NHS Foundation Trust, Middlesbrough, UK.;Hull York Medical School, University of York, York, UK.;Molecular and Clinical Sciences Research Institute, St George's University of;London, London, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37624589/ |
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