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Liu YM, Wang W, Zhang X, Lei F, Qin JJ, Huang X, Li R, Lin L, Chen M, Ji YX, Zhang P, Zhang XJ, She ZG, Cai J, Xu C, Shen Z, Li H. The rising death burden of atrial fibrillation and flutter in low-income regions and younger populations. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1122790. [PMID: 38455885 PMCID: PMC10910937 DOI: 10.3389/fepid.2023.1122790] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/16/2023] [Indexed: 03/09/2024]
Abstract
Objective The aim of the study was to depict the global death burden of atrial fibrillation and/or flutter (AFF) between 1990 and 2019 and predict this burden in the next decade. Methods We retrieved annual death data on cases and rates of AFF between 1990 and 2019 from the Global Burden of Disease (GBD) Study 2019 and projected the trends for 2020-2029 by developing the Bayesian age-period-cohort model. Results The global number of deaths from AFF increased from 117,038.00 in 1990 to 315,336.80 in 2019. This number is projected to reach 404,593.40 by 2029. The age-standardized mortality rates (ASMRs) of AFF have increased significantly in low- to middle-sociodemographic index (SDI) regions, which will surpass that in high SDI regions and reach above 4.60 per 100,000 by 2029. Globally, women have a higher ASMR than men, which is largely attributed to disproportionately higher mortality in women than men in lower SDI regions. Notably, AFF-related premature mortality continues to worsen worldwide. A pandemic of high systolic blood pressure and high body mass index (BMI) largely contributes to AFF-associated death. In particular, low- to middle-SDI regions and younger populations are increasingly affected by the rapidly growing current and future risk of high BMI. Conclusion The global death burden of AFF in low-income countries and younger generations have not been sufficiently controlled in the past and will continue growing in the future, which is largely attributed to metabolic risks, particularly for high BMI. There is an urgent need to implement effective measures to control AFF-related mortality.
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Affiliation(s)
- Ye-Mao Liu
- Department of Cardiology, Huanggang Central Hospital, Huanggang, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Wenxin Wang
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Renmin Hospital of Wuhan University, School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Xingyuan Zhang
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Renmin Hospital of Wuhan University, School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Fang Lei
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Renmin Hospital of Wuhan University, School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Juan-Juan Qin
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Renmin Hospital of Wuhan University, School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Xuewei Huang
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Renmin Hospital of Wuhan University, School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Ruyan Li
- Northfield Mount Hermon School, Gill, MA, United States
| | - Lijin Lin
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Renmin Hospital of Wuhan University, School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Mingming Chen
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Renmin Hospital of Wuhan University, School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Yan-Xiao Ji
- Institute of Model Animal, Wuhan University, Wuhan, China
- Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Peng Zhang
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Renmin Hospital of Wuhan University, School of Basic Medical Science, Wuhan University, Wuhan, China
- Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiao-Jing Zhang
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Renmin Hospital of Wuhan University, School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Zhi-Gang She
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Renmin Hospital of Wuhan University, School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Jingjing Cai
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Chengsheng Xu
- Department of Cardiology, Huanggang Central Hospital, Huanggang, China
| | - Zhengjun Shen
- Department of Cardiology, Huanggang Central Hospital, Huanggang, China
| | - Hongliang Li
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Renmin Hospital of Wuhan University, School of Basic Medical Science, Wuhan University, Wuhan, China
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Mayet M, Vallabh K, Hendrikse C. Low prevalence of atrial fibrillation in ischaemic stroke: Underestimating a modifiable risk factor. Afr J Emerg Med 2021; 11:39-45. [PMID: 33437592 PMCID: PMC7786038 DOI: 10.1016/j.afjem.2020.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/06/2020] [Accepted: 10/27/2020] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Cerebrovascular disease remains one of the leading causes of morbidity and mortality globally. In South Africa, it was the fourth leading cause of death in 2016, responsible for 5.1% of all deaths - the leading cause of death in individuals 65 years and older. Atrial fibrillation accounts for 15% of all strokes and 25% are diagnosed when patients present with a stroke. We set out to determine the prevalence of atrial fibrillation in patients with confirmed ischaemic strokes in a district level hospital in the Western Cape, South Africa. METHODS This descriptive study was conducted at Mitchells Plain Hospital in Cape Town and data was collected over a one-year period. Patients diagnosed with a stroke were identified from an electronic patient register and relevant radiology and clinical data were sourced retrospectively. The diagnosis of ischaemic stroke was confirmed by a CT scan report and ECGs were independently screened by two Emergency Physicians. Ethical approval was granted by the University of Cape Town Human Research Ethics Committee [790/2018]. RESULTS The proportion of adult patients with a stroke diagnosis was 2%. Of the included cases, 80% had ischaemic strokes and 11% had haemorrhagic strokes. 11% of all patients with ischaemic strokes had atrial fibrillation, 67% of those presumed new. A total of 60 (15%) of all patients with ischaemic stroke were aged 45 years or younger. The inpatient mortality rate was statistically higher in patients who had atrial fibrillation (26% vs 7%, p < 0.001). CONCLUSION With the increasing population life expectancy, and prevalence of cardiovascular disease the prevalence of atrial fibrillation and its complications will increase. Since the risk of stroke related to atrial fibrillation can be reduced significantly by oral anticoagulation, further studies should aim to explore barriers and challenges to effective screening.
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Affiliation(s)
- Mohammed Mayet
- University of Cape Town Faculty of Health Sciences, Division of Emergency Medicine, Cape Town, Western Cape, ZA, South Africa
| | - Kamil Vallabh
- University of Cape Town Faculty of Health Sciences, Division of Emergency Medicine, Cape Town, Western Cape, ZA, South Africa
| | - Clint Hendrikse
- University of Cape Town Faculty of Health Sciences, Division of Emergency Medicine, Cape Town, Western Cape, ZA, South Africa
- Mitchells Plain Hospital and Heideveld Hospital, Emergency Centre, Cape Town, Western Cape, ZA, South Africa
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