医学
心房颤动
危险系数
内科学
置信区间
比例危险模型
人口
冲程(发动机)
心力衰竭
队列研究
心脏病学
机械工程
环境卫生
工程类
作者
Christian Paludan‐Müller,Oliver Bundgaard Vad,Niels Kjær Stampe,Søren Zöga Diederichsen,Laura Andreasen,Laia Meseguer Monfort,Emil Loldrup Fosbøl,Lars Køber,Christian Torp‐Pedersen,Jesper Hastrup Svendsen,Morten Olesen
标识
DOI:10.1093/eurheartj/ehae216
摘要
Abstract Background and Aims Patients with atrial fibrillation (AF) are at increased risks of cardiovascular diseases and mortality, but risks according to age at diagnosis have not been reported. This study investigated age-specific risks of outcomes among patients with AF and the background population. Methods This nationwide population-based cohort study included patients with AF and controls without outcomes by the application of exposure density matching on the basis of sex, year of birth, and index date. The absolute risks and hazard rates were stratified by age groups and assessed using competing risk survival analyses and Cox regression models, respectively. The expected differences in residual life years among participants were estimated. Results The study included 216 579 AF patients from year 2000 to 2020 and 866 316 controls. The mean follow-up time was 7.9 years. Comparing AF patients with matched controls, the hazard ratios among individuals ≤50 years was 8.90 [95% confidence interval (CI), 7.17–11.0] for cardiomyopathy, 8.64 (95% CI, 7.74–9.64) for heart failure, 2.18 (95% CI, 1.89–2.52) for ischaemic stroke, and 2.74 (95% CI, 2.53–2.96) for mortality. The expected average loss of life years among individuals ≤50 years was 9.2 years (95% CI, 9.0–9.3) years. The estimates decreased with older age. Conclusions The findings show that earlier diagnosis of AF is associated with a higher hazard ratio of subsequent myocardial disease and shorter life expectancy. Further studies are needed to determine causality and whether AF could be used as a risk marker among particularly younger patients.
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