Incidence, mortality, and sex differences of non-valvular atrial fibrillation: A population-based study

Abstract

Background: It is unclear whether the incidence of non-valvular atrial fibrillation (NVAF) has been increasing over time. We aimed to provide contemporary estimates of the incidence and case-fatality of NVAF in a well-defined population. Methods and Results: We used the computerized databases of the Régie de l'assurance maladie du Québec (RAMQ), responsible for administering the universal health care services for all its residents, to identify a population-based cohort of 243 800 patients with an incident diagnosis of NVAF during 2000-2009. The incidence rate of NVAF, age- and sex-standardized to the 2004 population of Québec, was 32.4 (95% confidence interval, 32.3 to 32.5) per 10 000 per year. There was no evidence of an increasing incidence of NVAF during the 10-year study period. The incidence rate was higher in men compared with women (ageadjusted incidence rate ratio 1.51; 95% CI 1.50 to 1.52). The 30-day case-fatality was 9.2% (95% CI 9.0 to 9.3), higher for men (10.0%; 95% CI 9.8 to 10.1) than women (8.5; 95% CI 8.3 to 8.6), and increasing with age, ranging from around 1% for cases aged < 40 years to around 16% for cases aged ≥80. Conclusion: Current incidence estimates illustrate the significant burden of NVAF. Mortality remains particularly high around the time of diagnosis, and case-fatality increases with age, being systematically higher in men than women.