Tang Juan, Zhang Qingwei, Peng Shengxian, Li Huan, Hu Weike, Hao Min, Liu Yue, Sun Mengyan, Cao Wenzhai, Yin Niying, Liu Xiaozhu, Xu Te
Department of Scientific Research, Zigong First People's Hospital, Zigong, China.
Division of Gastroenterology and Hepatology, Key Laboratory Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China.
Front Cardiovasc Med. 2024 Aug 29;11:1401722. doi: 10.3389/fcvm.2024.1401722. eCollection 2024.
Atrial fibrillation and flutter, collectively referred to as AF/AFL, pose substantial public health challenges across nations of different economic statuses.
This research is intended to assess the discrepancies in global, regional, and national trends in DALYs for atrial fibrillation and flutter throughout 1990 and 2019.
The GBD 2019 report included statistics on AF/AFL. An age-period-cohort (APC) model was used to calculate the changes in DALYs from ages 30 to 34 years up to 95 + years. The model calculated both net drifts and local drifts in DALYs. In addition, we analysed the relative risks for certain time periods and birth cohorts from 1990 to 2019 in order to assess their impact. In order to measure the changes over time in the age-standardized rate (ASR) of DALYs caused by AF/AFL, we calculated the average annual percentage changes (AAPCs) based on age, gender, socio-demographic index (SDI), and location. This approach enables us to analyse the impact of age, period, and cohort on trends in DALYs, which may uncover disparities in the management of AF/AFL.
The global number of DALYs cases was 8,393,635 [95% uncertainty interval (UI): 6,693,987 to 10,541,461], indicating a 121.6% rise (95% UI: 111.5 to 132.0) compared to 1990. From 1990 to 2019, the worldwide ASR of DALYs decreased by 2.61% (95% UI -6.9 to 1.3). However, the other SDI quintiles, except for high SDI and high-middle SDI, had an increase. During the last three decades, high-income nations in the Asia Pacific region had the most significant reduction in ASR of DALYs, whereas Central Asia experienced the highest rise (with a net drift of -0.9% [95% Confidence Interval (CI): -1.0 to -0.9] and 0.6% [95% CI: 0.5 to 0.7], respectively). Approximately 50% of the burden of AF/AFL has been transferred from areas with high and high-middle SDI to those with lower SDI. There was an inverse relationship between the AAPC and the SDI. In addition, men and older individuals were shown to have a greater burden of AF/AFL DALYs.
The findings of this research demonstrate that the worldwide impact of AF/AFL remains significant and increasing, with the burden differing depending on SDI. The exhaustive and comparable estimates provided by these results may contribute to international efforts to attain equitable AF/AFL control.
心房颤动和心房扑动统称为房颤/房扑，在不同经济状况的国家都构成了重大的公共卫生挑战。
本研究旨在评估1990年至2019年期间全球、区域和国家层面房颤/房扑伤残调整生命年（DALYs）趋势的差异。
《2019年全球疾病负担研究》报告包含了房颤/房扑的统计数据。采用年龄-时期-队列（APC）模型计算30至34岁至95岁及以上年龄段DALYs的变化。该模型计算了DALYs的净漂移和局部漂移。此外，我们分析了1990年至2019年某些时间段和出生队列的相对风险，以评估其影响。为了衡量房颤/房扑导致的DALYs年龄标准化率（ASR）随时间的变化，我们根据年龄、性别、社会人口指数（SDI）和地理位置计算了平均年度百分比变化（AAPCs）。这种方法使我们能够分析年龄、时期和队列对DALYs趋势的影响，这可能揭示房颤/房扑管理方面的差异。
全球DALYs病例数为8393635例[95%不确定区间（UI）：6693987至10541461例]，与1990年相比增长了121.6%（95% UI：111.5至132.0）。1990年至2019年，全球DALYs的ASR下降了2.61%（95% UI -6.9至1.3）。然而，除高SDI和高中SDI外，其他SDI五分位数均有所上升。在过去三十年中，亚太地区的高收入国家DALYs的ASR下降最为显著，而中亚地区上升幅度最大（净漂移分别为-0.9%[95%置信区间（CI）：-1.0至-0.9]和0.6%[95% CI：0.5至0.7]）。房颤/房扑负担约50%已从高SDI和高中SDI地区转移到低SDI地区。AAPC与SDI呈负相关。此外，男性和老年人的房颤/房扑DALYs负担更重。
本研究结果表明，房颤/房扑在全球范围内的影响仍然很大且在增加，负担因SDI而异。这些结果提供的详尽且可比的估计可能有助于国际社会为实现公平的房颤/房扑控制所做的努力。
