AF deaths declined from 1972 to 2015, but AF impacted life expectancy
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Researchers observed no temporal trends in HRs regarding the link between atrial fibrillation and all-cause mortality in participants from the Framingham Heart Study.
The study also found that there was a 2-year gap in mean number of life-years lost when patients with AF were compared with those without the condition, according to the study published in The BMJ.
“Improvement in the excess mortality associated with atrial fibrillation may be explained by continued improvements in early detection, management and treatment,” Ludovic Trinquart, PhD, associate professor of biostatistics at Boston University School of Public Health, said in a press release. “But the findings of this new study highlight that atrial fibrillation remains a very serious condition. Advances in prevention will be essential to stem the epidemic of atrial fibrillation and reduce its associated mortality.”
Nicklas Vinter, MD, physician at Silkeborg Regional Hospital in Denmark and doctoral student at Aarhus University in Denmark, and colleagues analyzed participants from the Framingham Heart Study aged 45 to 95 years who were free from AF at entry into the study. Data were obtained from three periods: 1972-1985 (n = 5,671), 1986-2000 (n = 6,177) and 2001-2015 (n = 6,174). Although there were 10,816 patients without AF, 5,660 contributed data to more than one period.
The primary outcome was all-cause mortality.
During follow-up, 5.4% of patients developed AF from 1972 to 1985, 9.6% from 1986 to 2000 and 7.6% from 2001 to 2015.
After adjusting for time-varying covariates, there was no evidence of a temporal trend of HRs (P for trend = .7) from 1972 to 1985 (HR= 1.91; 95% CI, 1.67-2.19), from 1986 to 2000 (HR = 1.42; 95% CI, 1.29-1.56) and from 2001 to 2015 (HR = 1.69; 95% CI, 1.47-1.95).
Ten years after an AF diagnosis, the adjusted difference in restricted mean survival times between patients with AF and matched referents decreased by 31%. When assessed by periods, the difference was 2.85 years from 1972 to 1985 (95% CI, 3.21 to 2.5), 2.1 years from 1986 to 2000 (95% CI, 2.35 to 1.84) and 1.99 years from 2001 to 2015 (95% CI, 2.26 to 1.72; P for trend = .03).
“[A] reason for an expected reduction in mortality associated with newly diagnosed atrial fibrillation is the potential early identification of individuals at low risk because of increased awareness and use of routine electrocardiographs and extended electrocardiographic monitoring devices,” Vinter and colleagues wrote. “Individuals at low risk might have a more favorable prognosis because of starting treatments early for modifiable risk factors and prevention of stroke.”
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