TY - JOUR

T1 - Atrial fibrillation

T2 - age at diagnosis, incident cardiovascular events, and mortality

AU - Paludan-Müller, Christian

AU - Vad, Oliver B.

AU - Stampe, Niels K.

AU - Diederichsen, Søren Z.

AU - Andreasen, Laura

AU - Monfort, Laia M.

AU - Fosbøl, Emil L.

AU - Køber, Lars

AU - Torp-Pedersen, Christian

AU - Svendsen, Jesper H.

AU - Olesen, Morten S.

N1 - Publisher Copyright: © The Author(s) 2024.

PY - 2024

Y1 - 2024

N2 - Background and Aims Patients with atrial fibrillation (AF) are at increased risks of cardiovascular diseases and mortality, but risks according to age at diagnosis have not been reported. This study investigated age-specific risks of outcomes among patients with AF and the background population. Methods This nationwide population-based cohort study included patients with AF and controls without outcomes by the application of exposure density matching on the basis of sex, year of birth, and index date. The absolute risks and hazard rates were stratified by age groups and assessed using competing risk survival analyses and Cox regression models, respectively. The expected differences in residual life years among participants were estimated. Results The study included 216 579 AF patients from year 2000 to 2020 and 866 316 controls. The mean follow-up time was 7.9 years. Comparing AF patients with matched controls, the hazard ratios among individuals ≤50 years was 8.90 [95% confidence interval (CI), 7.17–11.0] for cardiomyopathy, 8.64 (95% CI, 7.74–9.64) for heart failure, 2.18 (95% CI, 1.89–2.52) for ischaemic stroke, and 2.74 (95% CI, 2.53–2.96) for mortality. The expected average loss of life years among individuals ≤50 years was 9.2 years (95% CI, 9.0–9.3) years. The estimates decreased with older age. Conclusions The findings show that earlier diagnosis of AF is associated with a higher hazard ratio of subsequent myocardial disease and shorter life expectancy. Further studies are needed to determine causality and whether AF could be used as a risk marker among particularly younger patients.

AB - Background and Aims Patients with atrial fibrillation (AF) are at increased risks of cardiovascular diseases and mortality, but risks according to age at diagnosis have not been reported. This study investigated age-specific risks of outcomes among patients with AF and the background population. Methods This nationwide population-based cohort study included patients with AF and controls without outcomes by the application of exposure density matching on the basis of sex, year of birth, and index date. The absolute risks and hazard rates were stratified by age groups and assessed using competing risk survival analyses and Cox regression models, respectively. The expected differences in residual life years among participants were estimated. Results The study included 216 579 AF patients from year 2000 to 2020 and 866 316 controls. The mean follow-up time was 7.9 years. Comparing AF patients with matched controls, the hazard ratios among individuals ≤50 years was 8.90 [95% confidence interval (CI), 7.17–11.0] for cardiomyopathy, 8.64 (95% CI, 7.74–9.64) for heart failure, 2.18 (95% CI, 1.89–2.52) for ischaemic stroke, and 2.74 (95% CI, 2.53–2.96) for mortality. The expected average loss of life years among individuals ≤50 years was 9.2 years (95% CI, 9.0–9.3) years. The estimates decreased with older age. Conclusions The findings show that earlier diagnosis of AF is associated with a higher hazard ratio of subsequent myocardial disease and shorter life expectancy. Further studies are needed to determine causality and whether AF could be used as a risk marker among particularly younger patients.

KW - Atrial fibrillation

KW - Cardiomyopathy

KW - DCM

KW - Heart failure

KW - Ischaemic stroke

KW - Mortality

U2 - 10.1093/eurheartj/ehae216

DO - 10.1093/eurheartj/ehae216

M3 - Journal article

C2 - 38592444

AN - SCOPUS:85197031973

VL - 45

SP - 2119

EP - 2129

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 24

ER -