Department of Cardiovascular Medicine, Shaanxi Provincial People's Hospital, Xi'an, China.
Department of Neurology, Xi'an Ninth Hospital Affiliated to Medical College of Xi'an Jiaotong University, Xi'an, China.
Heart. 2021 Jun;107(11):881-887. doi: 10.1136/heartjnl-2020-317656. Epub 2020 Nov 4.
This study aimed to estimate the global burden of atrial fibrillation/atrial flutter (AF/AFL).
We retrieved data from the Global Health Data Exchange query tool and estimated the age-standardised rates (ASRs) of prevalence, incidence and disability-adjusted life-years (DALYs) of AF/AFL, as well as the population attributable fraction (PAF) of risk factors contributing to DALYs. ASRs and sociodemographic index (SDI) were assessed using Pearson's correlation coefficients.
In 2017, there were 37.6 million (95% uncertainty interval (UI) 32.5 to 42.6 million) individuals with AF/AFL globally. The prevalence rates increased with increased SDI values in most regions for all years. Men had a higher prevalence than women across all regions except for China. From 1990 to 2017, global prevalence rate decreased by 5.08% (95% UI -6.24% to -3.82%), with the largest decrease noted in the region with high SDI values. The global DALYs rate declined by 2.53% (95% UI -4.16 to -0.29). PAF of elevated systolic blood pressure for attributable DALYs accounted for the highest percentage, followed by high body mass index, alcohol use, high-sodium diet, smoking and lead exposure.
Although the ASRs of prevalence, incidence and DALYs decreased from 1990 to 2017, the absolute number of patients with AF/AFL, annual number of new AF/AFL cases and DALYs lost due to AF/AFL increased. This indicates that the burden of AF/AFL is likely to remain high. Systematic surveillance is needed to better identify and manage AF/AFL so as to prevent its various risk factors and complications.
本研究旨在估算心房颤动/心房扑动(AF/AFL)的全球负担。
我们从全球健康数据交换查询工具中检索数据,估计了 AF/AFL 的年龄标准化患病率(ASR)、发病率和伤残调整生命年(DALY),以及导致 DALY 的危险因素的人群归因分数(PAF)。使用 Pearson 相关系数评估 ASR 和社会人口指数(SDI)。
2017 年,全球有 3760 万人(95%置信区间[95%UI]为 3250 万至 4260 万人)患有 AF/AFL。在大多数地区,所有年份的患病率均随 SDI 值的增加而增加。除中国外,所有地区男性的患病率均高于女性。1990 年至 2017 年,全球患病率下降了 5.08%(95%UI-6.24%至-3.82%),高 SDI 地区的降幅最大。全球 DALY 率下降了 2.53%(95%UI-4.16%至-0.29%)。升高的收缩压导致 DALY 的 PAF 占比最高,其次是高体重指数、饮酒、高钠饮食、吸烟和铅暴露。
尽管 1990 年至 2017 年 AF/AFL 的 ASR 患病率、发病率和 DALY 有所下降,但 AF/AFL 患者的绝对人数、新发 AF/AFL 病例的年数以及因 AF/AFL 丧失的 DALY 数均有所增加。这表明 AF/AFL 的负担可能仍然很高。需要进行系统监测,以更好地识别和管理 AF/AFL,从而预防其各种危险因素和并发症。