Wu, J orcid.org/0000-0001-6093-599X, Nadarajah, R, Nakao, YM et al. (5 more authors) (2022) Temporal trends and patterns in atrial fibrillation incidence: A population-based study of 3·4 million individuals. The Lancet Regional Health Europe, 17. 100386. ISSN 2666-7762
Abstract
Background:
Population-based studies of atrial fibrillation (AF) incidence are needed to inform health-service planning, but evidence is conflicting. We assessed trends of AF incidence in a large general population cohort from England.
Methods:
We used linked primary and secondary electronic health records of 3.4 million individuals. Eligible patients aged 16 years and older contributed data between Jan 2 1998 and Dec 31 2017. For patients with incident AF, we extracted baseline characteristics, comorbidities, socioeconomic status and geographic region. We calculated standardised rates by applying direct age and sex standardisation to the 2013 European Standard Population. We applied year-specific, age-specific and sex-specific incidence to UK census mid-year population estimates for yearly total incident AF.
Findings:
Comparing 2017 to 1998 standardised AF incidence increased by 30% (322 vs. 247 per 100 000 person-years; adjusted incidence ratio [IRR] 1·30, 95% CI 1·27–1·33). Absolute number of incident AF increased by 72% (202 333 vs. 117 880), due to an increasing number of older persons. Comorbidity burden at diagnosis of AF increased (3·74 [SD 2·29] vs 2·58 [1·83]; adjusted difference 1·26, 95% CI 1·14–1·39). The age of AF diagnosis declined in the most deprived individuals compared to the most affluent (adjusted difference 0·74 years, 0·62–0·88). Across the study period, age-standardised incidence was higher in men than women (IRR 1·49; 95% CI 1·46–1·52), and men were younger at diagnosis (adjusted difference 5·53 years; 95% CI 5·36 to 5·69). Socioeconomically deprived individuals had more comorbidities and a higher incidence of AF than the most affluent individuals (IRR 1·20; 95% CI 1·15–1·24).
Interpretation:
In England AF incidence has increased, and the socioeconomic gradient in age at diagnosis and comorbidity burden widened. This changing burden requires policy-based interventions to achieve health equity.
Funding:
British Heart Foundation and National Institute for Health Research.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
Keywords: | Atrial fibrillation, Electronic health records, Incidence, Multimorbidity |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Dentistry (Leeds) > Applied Health and Clinical Translation (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Clinical & Population Science Dept (Leeds) |
Funding Information: | Funder Grant number British Heart Foundation FS/20/12/34789 |
Depositing User: | Symplectic Publications |
Date Deposited: | 31 Mar 2022 16:20 |
Last Modified: | 24 Mar 2025 15:41 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.lanepe.2022.100386 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:185251 |