• J. Korean Med. Sci. · Dec 2024

    Risk of Death From Various Causes According to Prevalent Atrial Fibrillation: A Nationwide Population-Based Study.

    • Young-Kwan Kim, So-Ryoung Lee, Eue-Keun Choi, Hyun Jin Ahn, Nan Young Bae, Kyung-Yeon Lee, JungMin Choi, Hyo-Jeong Ahn, Soonil Kwon, Kyungdo Han, Seil Oh, and LipGregory Y HGYH0000-0002-7566-1626Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Chest &.
    • Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
    • J. Korean Med. Sci. 2024 Dec 9; 39 (47): e306e306.

    BackgroundAtrial fibrillation (AF) is associated with increased risks of adverse events including stroke and all-cause death. Understanding the pattern of causes of death (COD) with the relative risks in patients with AF compared to the non-AF population is essential in planning optimal care for patients with AF. We aimed to analyze the COD and its relative risks in patients with AF, using a nationwide population-based cohort.MethodsUsing the Korean nationwide claims database, people aged 40 or older who received health examinations in 2009 were included if they had no missing values (n = 6,877,929). In total the study included 40,585 people with AF and 6,837,344 without AF. COD was defined by International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnostic codes. Comparison between the AF and non-AF groups was performed with Multivariate Cox proportional regression model.ResultsIn the AF group, cardiovascular diseases were the most common COD, causing 39.8% of all deaths, compared with 19.0% for non-AF subjects. The AF group was associated with a higher risk of death from cardiovascular and cerebrovascular diseases by almost 3-fold than the matched non-AF group (hazard ratios [HR], 3.082; 95% confidence intervals [CIs], 2.963-3.205 for cardiovascular diseases; HR, 2.981; 95% CI, 2.799-3.175 for cerebrovascular diseases, all P < 0.001). Among patients with AF, the risks of all-cause, cardiovascular, and cerebrovascular death were well-stratified by CHA₂DS₂-VASc scores. The risk of cerebrovascular death was 11 times higher among patients with a CHA₂DS₂-VASc score ≥ 7.ConclusionCompared to non-AF individuals, patients with AF had a higher risk of death from cardiovascular and cerebrovascular diseases, and the mortality risks were well-stratified by the CHA₂DS₂-VASc score. Integrated care management of cardiovascular and cerebrovascular diseases for patients with AF might help mitigate mortality.© 2024 The Korean Academy of Medical Sciences.

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