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Global, regional, and national burden of heart failure associated with atrial fibrillation

Sanjeewa Kularatna1, Amarzaya Jadambaa1,2, Sumudu Hewage3

  • 1Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.

BMC Cardiovascular Disorders
|July 10, 2023
PubMed

Insights

Atrial fibrillation (AF) contributes significantly to the global burden of heart failure, with a 49.8% increase in cases since 1990. However, high-income nations show declining rates, suggesting effective management strategies are possible.

Area of Science:

  • Cardiology
  • Epidemiology
  • Public Health

Background:

  • Heart failure is a major global health concern, with Atrial fibrillation (AF) identified as a significant modifiable risk factor.
  • Estimates for the specific burden of heart failure attributable to AF were previously lacking.
  • This study aimed to quantify the global, regional, and national impact of heart failure associated with AF.

Approach:

  • Utilized a comparative risk assessment methodology to determine disease burden, focusing on prevalence and Years Lived with Disability (YLD).
  • Calculated the population-attributable fraction for heart failure and AF using AF prevalence data and relative risks derived from a systematic review.
  • Sourced heart failure burden data from the Global Burden of Disease database.

Key Points:

  • Globally, 2.6% of the heart failure burden is linked to AF, affecting 1.5 million people in 2019, a nearly 50% rise since 1990.
  • Prevalence was highest in South-East Asia, East Asia, and Oceania, while YLD burden was concentrated in Central and Eastern Europe and Central Asia.
  • High-income countries demonstrated a notable decrease in age-standardized prevalence and YLD rates for AF-associated heart failure between 1990 and 2019.

Conclusions:

  • The burden of heart failure linked to AF has risen considerably in recent decades, despite advancements in AF management.
  • Declining trends in high-income countries suggest that reducing the burden of AF-related heart failure is achievable through effective interventions.
  • Further research and targeted public health strategies are warranted to address the growing global impact of AF on heart failure.
Abstract

Keywords:
Atrial fibrillationGlobal burdenHeart failureNational burdenPopulation attributable fractionRegional burden

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