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

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)339-348
Number of pages10
JournalChest
Volume153
Issue number2
DOIs
Publication statusPublished - Feb 1 2018

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Taiwan
Atrial Fibrillation
Cohort Studies
Heart Failure
Stroke
Mortality
Sudden Cardiac Death
Incidence

Keywords

  • adverse events
  • atrial fibrillation
  • incidence
  • lifetime risk
  • prevalence

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Lifetime Risks, Projected Numbers, and Adverse Outcomes in Asian Patients With Atrial Fibrillation : A Report From the Taiwan Nationwide AF Cohort Study. / Chao, Tze Fan; Liu, Chia Jen; Tuan, Ta Chuan; Chen, Tzeng Ji; Hsieh, Ming Hsiung; Lip, Gregory Y.H.; Chen, Shih Ann.

In: Chest, Vol. 153, No. 2, 01.02.2018, p. 339-348.

Research output: Contribution to journalArticle

Chao, Tze Fan ; Liu, Chia Jen ; Tuan, Ta Chuan ; Chen, Tzeng Ji ; Hsieh, Ming Hsiung ; Lip, Gregory Y.H. ; Chen, Shih Ann. / Lifetime Risks, Projected Numbers, and Adverse Outcomes in Asian Patients With Atrial Fibrillation : A Report From the Taiwan Nationwide AF Cohort Study. In: Chest. 2018 ; Vol. 153, No. 2. pp. 339-348.
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AU - Tuan, Ta Chuan

AU - Chen, Tzeng Ji

AU - Hsieh, Ming Hsiung

AU - Lip, Gregory Y.H.

AU - Chen, Shih Ann

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N2 - 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.

AB - 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.

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