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Published on: February 26, 2013
Temporal Trends in Multimorbidity Patterns in Patients With Atrial Fibrillation-A Nationwide Cohort Study
Sanni Reinilä1, Niklas Kiuru1, Ville Langén2
1Department of Internal Medicine, University of Turku, Turku, Finland.
Insights
Multimorbidity is common and increasing in patients with atrial fibrillation (AF). This trend highlights the need for comprehensive care strategies for this growing patient population.
Area of Science:
- Cardiology
- Geriatrics
- Public Health
Background:
- Increasing prevalence of atrial fibrillation (AF) and multimorbidity due to population aging.
- Lack of comprehensive data on temporal trends in multimorbidity among AF patients.
Purpose of the Study:
- To investigate temporal trends in multimorbidity among patients with incident atrial fibrillation (AF).
- To characterize the prevalence and burden of comorbidities in a nationwide AF cohort.
Main Methods:
- Utilized the Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) cohort study (2009-2018).
- Extracted comorbidity data from national registers with a 5-year look-back period.
- Applied established categorization to assess multimorbidity burden and temporal changes.
Main Results:
- 85% of incident AF patients had ≥2 comorbidity groups; 28% had ≥6.
- Mean number of distinct comorbidity groups increased from 3.9 to 4.2 (2009-2018), remaining significant after age/sex adjustment.
- Hypertension, metabolic diseases, diabetes, and cardiovascular diseases were most prevalent; ischemic heart disease prevalence declined.
Conclusions:
- Multimorbidity is highly prevalent and increasing in patients with atrial fibrillation.
- Findings underscore the necessity of a holistic management approach for AF patients with multiple comorbidities.
Background:
The prevalence of both atrial fibrillation (AF) and multimorbidity is increasing with population aging. However, reliable and comprehensive data on temporal trends in multimorbidity among patients with AF are lacking.
Methods:
The nationwide Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) cohort study includes all patients with incident AF between 2009 and 2018. Data on comorbidities were obtained from national healthcare, reimbursement and prescription registers using a fixed 5-year look-back period. A previously established comorbidity categorisation was applied to characterise multimorbidity burden. Temporal trends in the prevalence of common comorbidities and in the number of distinct diagnosis groups at the time of new-onset AF were calculated.
Results:
Overall, 85% of 196,536 individuals with new onset AF had diagnoses from ≥ 2 comorbidity groups and 28% from ≥ 6 comorbidity groups. Mean number of different groups increased from 3.9 to 4.2 between 2009 and 2018. Although adjustment for age attenuated the association, the increase in multimorbidity over time remained significant after adjustment for age and sex. Multimorbidity was more common in women than in men (4.2 vs. 3.9) and increased with age. Hypertensive diseases, obesity and other metabolic diseases, diabetes and other cardiovascular diseases were most prevalent. The prevalence of ischaemic heart disease and other diseases of the heart and pulmonary circulation declined during the study period.
Conclusions:
Multimorbidity is highly prevalent and increasing among patients with AF, highlighting the importance of a holistic management approach.
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