Clua-Espuny Josep-Lluis, Molto-Balado Pedro, Lucas-Noll Jorgina, Panisello-Tafalla Anna, Muria-Subirats Eulalia, Clua-Queralt Josep, Queralt-Tomas Lluïsa, Reverté-Villarroya Silvia
Primary Health-Care Centre, Institut Català de la Salut, Primary Care Service (SAP), EAP Tortosa-Est, Plaça Carrilet s/núm, 43500 Tortosa, Spain.
Research Support Unit Terres de l'Ebre, Institut Universitarid'Investigació en Atenció Primària Jordi Gol (IDIAP JGol), USR Terres de l'Ebre, 43500 Tortosa, Spain.
Biomedicines. 2023 Apr 7;11(4):1116. doi: 10.3390/biomedicines11041116.
(1) Background: AF-related strokes will triple by 2060, are associated with an increased risk of cognitive decline, and alone or in combination, will be one of the main health and economic burdens on the European population. The main goal of this paper is to describe the incidence of new AF associated with stroke, cognitive decline and mortality among people at high risk for AF. (2) Methods: Multicenter, observational, retrospective, community-based studies were conducted from 1 January 2015 to 31 December 2021. The setting was primary care centers. A total of 40,297 people aged ≥65 years without previous AF or stroke were stratified by AFrisk at 5 years. The main measurements were the overall incidence density/1000 person-years (CI95%) of AF and stroke, prevalence of cognitive decline, and Kaplan-Meier curve. (3) Results: In total, 46.4% women, 77.65 ± 8.46 years old on average showed anAF incidence of 9.9/10/year (CI95% 9.5-10.3), associated with a four-fold higher risk of stroke (CI95% 3.4-4.7), cognitive impairment(OR 1.34 (CI95% 1.1-1.5)), and all-cause mortality (OR 1.14 (CI95% 1.0-1.2)), but there was no significant difference in ischemic heart disease, chronic kidney disease, or peripheral arteriopathy. Unknown AF was diagnosed in 9.4% and of these patients, 21.1% were diagnosed with new stroke. (4) Conclusions: The patients at high AF risk (Q4th) already had an increased cardiovascular risk before they were diagnosed with AF.
（1）背景：到2060年，与房颤相关的中风病例将增加两倍，与认知能力下降风险增加相关，且无论单独出现还是与其他因素共同作用，都将成为欧洲人口面临的主要健康和经济负担之一。本文的主要目的是描述房颤高危人群中与中风、认知能力下降和死亡率相关的新发房颤的发生率。（2）方法：于2015年1月1日至2021年12月31日开展了多中心、观察性、回顾性、基于社区的研究。研究地点为基层医疗中心。共有40297名年龄≥65岁且既往无房颤或中风的人按5年房颤风险进行分层。主要测量指标为房颤和中风的总体发病率密度/每1000人年（95%置信区间）、认知能力下降的患病率以及Kaplan-Meier曲线。（3）结果：总体而言，46.4%为女性，平均年龄77.65±8.46岁，房颤发生率为9.9/1000人年（95%置信区间9.5 - 10.3），中风风险高四倍（95%置信区间3.4 - 4.7），认知障碍（比值比1.34（95%置信区间1.1 - 1.5）），全因死亡率（比值比1.14（95%置信区间1.0 - 1.2）），但在缺血性心脏病、慢性肾病或外周动脉病方面无显著差异。9.4%的患者被诊断为隐匿性房颤，其中21.1%的患者被诊断为新发中风。（4）结论：房颤高危（第4四分位数）患者在被诊断为房颤之前就已经存在心血管风险增加的情况。
