• Chest · Feb 2018

    Lifetime Risks, Projected Numbers and Adverse Outcomes in Asian Patients with Atrial Fibrillation: A Report from the Taiwan Nationwide AF Cohort Study.

    • Tze-Fan Chao, Chia-Jen Liu, Ta-Chuan Tuan, Tzeng-Ji Chen, Ming-Hsiung Hsieh, LipGregory Y HGYHUniversity of Birmingham Institute of Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom., and Shih-Ann Chen.
    • Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.
    • Chest. 2018 Feb 1; 153 (2): 453466453-466.

    BackgroundMost data on the clinical epidemiology of atrial fibrillation (AF) come from Western populations, and data for Asians are limited. We investigated the lifetime risk and projected number of AF among Asians. The annual risks of adverse events among patients with AF, time trends, and the risks compared with patients without AF were analyzed.MethodsBetween 2000 and 2011, 289,559 patients aged ≥ 20 years experienced new-onset AF in Taiwan. The incidence, prevalence, and lifetime risk of AF were calculated. The risk of adverse events among patients with AF were analyzed and compared with that of age- and sex-matched patients without AF.ResultsThe incidence of AF in year 2011 was 1.51 per 1,000 person-years, with a lifetime risk of AF being appropriately 1 in 7 for subjects aged > 20 years. The prevalence of AF is estimated to be 4.01% in 2050. Compared with patients without AF, AF was associated with an increased risk of mortality (adjusted hazard ratio [aHR], 2.61), heart failure (aHR, 3.31), ischemic stroke (aHR, 3.34), dementia (aHR, 1.56), sudden cardiac death (aHR, 1.83), and myocardial infarction (aHR, 1.62); all P < .01. The risks of ischemic stroke, heart failure, and mortality were especially higher compared with patients without AF in the initial period (approximately 6 months) after AF was first diagnosed.ConclusionsThe burden of AF among Asian patients is increasing, with a lifetime risk of AF being 1 in 7. Optimized management of any associated comorbidities should be part of the holistic management approach for AF.Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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