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; Gregory Y. H. Lip

doi:10.3346/jkms.2024.39.e306

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
, Gregory Y. H. Lip

^*Corresponding author for this work

Research output: Contribution to journal › Journal article › Research › peer-review

1 Citation (Scopus)

71 Downloads (Pure)

Abstract

BACKGROUND: Atrial 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.

METHODS: Using 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.

RESULTS: In 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.

CONCLUSION: Compared 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.

Original language	English
Article number	e306
Journal	Journal of the Korean Physical Society
Volume	39
Issue number	47
Number of pages	14
ISSN	1011-8934
DOIs	https://doi.org/10.3346/jkms.2024.39.e306
Publication status	Published - 9 Dec 2024

Bibliographical note

Keywords

Humans
Atrial Fibrillation/mortality
Female
Male
Aged
Middle Aged
Republic of Korea/epidemiology
Proportional Hazards Models
Databases, Factual
Cause of Death
Risk Factors
Adult
Cardiovascular Diseases/mortality
Aged, 80 and over
Cerebrovascular Disorders/mortality
Prevalence
Cohort Studies
Stroke/mortality

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10.3346/jkms.2024.39.e306Licence: CC BY-NC 4.0

Kim et al. (2024). Risk of Death From Various Causes According to Prevalent Atrial Fibrillation - A Nationwide Population-Based StudyFinal published version, 1.57 MBLicence: CC BY-NC 4.0

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Cite this

@article{2c0e938fccc64fbc8607dbe11db8faac,

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

abstract = "BACKGROUND: Atrial 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.METHODS: Using 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.RESULTS: In 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.CONCLUSION: Compared 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.",

keywords = "Humans, Atrial Fibrillation/mortality, Female, Male, Aged, Middle Aged, Republic of Korea/epidemiology, Proportional Hazards Models, Databases, Factual, Cause of Death, Risk Factors, Adult, Cardiovascular Diseases/mortality, Aged, 80 and over, Cerebrovascular Disorders/mortality, Prevalence, Cohort Studies, Stroke/mortality",

author = "Young-Kwan Kim and So-Ryoung Lee and Eue-Keun Choi and Ahn, \{Hyun Jin\} and Bae, \{Nan Young\} and Kyung-Yeon Lee and JungMin Choi and Hyo-Jeong Ahn and Soonil Kwon and Kyungdo Han and Seil Oh and Lip, \{Gregory Y. H.\}",

note = "{\textcopyright} 2024 The Korean Academy of Medical Sciences.",

year = "2024",

month = dec,

day = "9",

doi = "10.3346/jkms.2024.39.e306",

language = "English",

volume = "39",

journal = "Journal of the Korean Physical Society",

issn = "1011-8934",

publisher = "Korean Physical Society",

number = "47",

}

TY - JOUR

T1 - Risk of Death From Various Causes According to Prevalent Atrial Fibrillation: A Nationwide Population-Based Study

AU - Kim, Young-Kwan

AU - Lee, So-Ryoung

AU - Choi, Eue-Keun

AU - Ahn, Hyun Jin

AU - Bae, Nan Young

AU - Lee, Kyung-Yeon

AU - Choi, JungMin

AU - Ahn, Hyo-Jeong

AU - Kwon, Soonil

AU - Han, Kyungdo

AU - Oh, Seil

AU - Lip, Gregory Y. H.

PY - 2024/12/9

Y1 - 2024/12/9

N2 - BACKGROUND: Atrial 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.METHODS: Using 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.RESULTS: In 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.CONCLUSION: Compared 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.

AB - BACKGROUND: Atrial 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.METHODS: Using 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.RESULTS: In 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.CONCLUSION: Compared 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.

KW - Humans

KW - Atrial Fibrillation/mortality

KW - Female

KW - Male

KW - Aged

KW - Middle Aged

KW - Republic of Korea/epidemiology

KW - Proportional Hazards Models

KW - Databases, Factual

KW - Cause of Death

KW - Risk Factors

KW - Adult

KW - Cardiovascular Diseases/mortality

KW - Aged, 80 and over

KW - Cerebrovascular Disorders/mortality

KW - Prevalence

KW - Cohort Studies

KW - Stroke/mortality

U2 - 10.3346/jkms.2024.39.e306

DO - 10.3346/jkms.2024.39.e306

M3 - Journal article

C2 - 39662500

SN - 1011-8934

VL - 39

JO - Journal of the Korean Physical Society

JF - Journal of the Korean Physical Society

IS - 47

M1 - e306

ER -

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

Abstract

Bibliographical note

Keywords

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