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

Young-Kwan Kim1, So-Ryoung Lee1,2, Eue-Keun Choi1,3

  • 1Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.

Journal of Korean Medical Science
|December 11, 2024
PubMed

Insights

Patients with atrial fibrillation (AF) face nearly triple the risk of death from cardiovascular and cerebrovascular diseases. Risk is stratified by CHA₂DS₂-VASc scores, highlighting the need for integrated care management.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Atrial fibrillation (AF) significantly increases risks of stroke and all-cause mortality.
  • Understanding cause-specific mortality patterns in AF patients is crucial for effective care planning.
  • This study analyzes causes of death (COD) and relative risks in AF patients versus the general population.

Purpose of the Study:

  • To analyze the causes of death (COD) in patients with atrial fibrillation (AF).
  • To compare the relative risks of mortality from various causes in AF patients compared to non-AF individuals.
  • To investigate the stratification of mortality risks by CHA₂DS₂-VASc scores in the AF population.

Main Methods:

  • Utilized the Korean nationwide claims database, including over 6.8 million individuals aged 40+ from 2009.
  • Included 40,585 patients with AF and 6,837,344 without AF, with no missing values.
  • Employed Multivariate Cox proportional regression to compare mortality between AF and non-AF groups, defining COD by ICD-10-CM codes.

Main Results:

  • Cardiovascular diseases were the most common COD in the AF group (39.8%), compared to 19.0% in the non-AF group.
  • AF patients showed a nearly 3-fold higher risk of death from cardiovascular (HR 3.082) and cerebrovascular diseases (HR 2.981).
  • Mortality risks (all-cause, cardiovascular, cerebrovascular) in AF patients were stratified by CHA₂DS₂-VASc scores, with a 11-fold higher risk of cerebrovascular death for scores ≥ 7.

Conclusions:

  • Patients with AF exhibit significantly elevated risks of death from cardiovascular and cerebrovascular diseases compared to non-AF individuals.
  • Mortality risks associated with AF are effectively stratified by the CHA₂DS₂-VASc score.
  • Integrated management of cardiovascular and cerebrovascular conditions in AF patients may reduce mortality.
Abstract

Keywords:
Atrial FibrillationCHA₂DS₂-VASc ScoreCause of DeathKoreaPopulation-Based Study

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