Frost Lars, Vestergaard Peter, Mosekilde Leif, Mortensen Leif Spange
Department of Cardiology, Aarhus Amtssygehus, Aarhus University Hospital, DK-8000 Aarhus C, Denmark.
Int J Cardiol. 2005 Aug 3;103(1):78-84. doi: 10.1016/j.ijcard.2004.08.024.
The incidence of diagnosed atrial fibrillation is increasing in the USA, England, Wales, Scotland and Denmark, and the mortality rate in patients with diagnosed atrial fibrillation has been reported to be declining in Scotland and Denmark. We undertook this study to examine recent trends in incidence and mortality in subjects with a hospital diagnosis of atrial fibrillation or flutter in Denmark from 1980 to 1999 by sex, 10-year age group and conditions of comorbidity.
We identified all individuals, aged 40-89 years, with an incident hospital diagnosis of atrial fibrillation or flutter in the Danish National Registry of Patients, and subjects were followed in the Danish Civil Registration System. We used multivariate Cox proportional hazard models to estimate trends in mortality.
Atrial fibrillation or flutter was diagnosed in 131,728 subjects (68,660 men and 63,068 women), and the incidence of a hospital diagnosis of atrial fibrillation or flutter more than doubled during the study period. The hazard ratios for mortality adjusted for 10-year age group, conditions of comorbidity and mortality trend in the Danish population in the last 5-year period compared to the first 5-year period were 0.80 (95% confidence interval 0.78-0.82) in men, and 0.82 (95% confidence interval 0.80-0.84) in women.
The incidence of a hospital diagnosis of atrial fibrillation or flutter more than doubled, and the 10-year age group- and comorbidity- and general population-adjusted mortality decreased, equally, from the first to the last 5-year period by 20% in men and 18% in women.
在美国、英格兰、威尔士、苏格兰和丹麦,确诊房颤的发病率正在上升,据报道,苏格兰和丹麦确诊房颤患者的死亡率一直在下降。我们开展这项研究,旨在按性别、10岁年龄组和合并症情况,研究1980年至1999年丹麦医院诊断为房颤或房扑的患者的发病率和死亡率的近期趋势。
我们在丹麦国家患者登记处确定了所有年龄在40 - 89岁、首次因房颤或房扑入院诊断的个体,并在丹麦民事登记系统中对这些受试者进行随访。我们使用多变量Cox比例风险模型来估计死亡率趋势。
131,728名受试者(68,660名男性和63,068名女性)被诊断为房颤或房扑,在研究期间,医院诊断为房颤或房扑的发病率增加了一倍多。与前5年相比,丹麦人群中在最后5年期间根据10岁年龄组、合并症情况和死亡率趋势调整后的男性死亡率风险比为0.80(95%置信区间0.78 - 0.82),女性为0.82(95%置信区间0.80 - 0.84)。
医院诊断为房颤或房扑的发病率增加了一倍多,从第一个5年到最后一个5年,经10岁年龄组、合并症和总体人群调整后的死亡率同样下降,男性下降了20%,女性下降了18%。