Temporal trends of cause-specific mortality after diagnosis of atrial fibrillation

Abstract

Background and Reports of outcomes after atrial fibrillation (AF) diagnosis are conflicting. The aim of this study was to investigate mortality Aims and hospitalization rates following AF diagnosis over time, by cause and by patient features. Methods Individuals aged ≥16 years with a first diagnosis of AF were identified from the UK Clinical Practice Research Datalink-GOLD dataset from 1 January 2001, to 31 December 2017. The primary outcomes were all-cause and cause-specific mortality and hospitalization at 1 year following diagnosis. Poisson regression was used to calculate rate ratios (RRs) for mortality and incidence RRs (IRRs) for hospitalization and 95% confidence intervals (CIs) comparing 2001/02 and 2016/17, adjusted for age, sex, region, socio-economic status, and 18 major comorbidities. Results Of 72 412 participants, mean (standard deviation) age was 75.6 (12.4) years, and 44 762 (61.8%) had ≥3 comorbidities. All-cause mortality declined (RR 2016/17 vs. 2001/02 0.72; 95% CI 0.65–0.80), with large declines for cardiovascular (RR 0.46; 95% CI 0.37–0.58) and cerebrovascular mortality (RR 0.41; 95% CI 0.29–0.60) but not for non-cardio/cerebrovascular causes of death (RR 0.91; 95% CI 0.80–1.04). In 2016/17, deaths caused from dementia (67, 8.0%), outstripped deaths from acute myocardial infarction, heart failure, and acute stroke combined (56, 6.7%, P