Prevalence, Incidence, and Lifetime Risk of Atrial Fibrillation in China New Insights Into the Global Burden of Atrial Fibrillation
Prevalence, Incidence, and Lifetime Risk of Atrial Fibrillation in China New Insights Into the Global Burden of Atrial Fibrillation
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DOI：
10.1378/chest.14-0321
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发表时间：
2015-01-01
期刊：
影响因子：
9.6
通讯作者：
Lip, Gregory Y. H.
中科院分区：
文献类型：
--
作者：
Guo, Yutao;Tian, Yingchun;Lip, Gregory Y. H.
背景：心房颤动（AF）的流行病学大部分是基于西方人群的数据。尽管亚洲人口众多，但亚洲国家AF的临床流行病学数据有限。本研究旨在调查中国新发房颤的患病率和发病率，以及终生风险，并确定导致其发展的临床危险因素。2001年至2012年，中国西南地区1000万人，使用Kaplan-Meier分析和考克斯回归计算AF事件的趋势。CHADS的用途（2）（充血性心力衰竭、高血压、年龄、糖尿病、中风[加倍]）和CHA（2）DS（2）-VASc（充血性心力衰竭、高血压、年龄>= 75岁[加倍]、糖尿病、中风[加倍]、血管疾病、年龄65-74岁和性别类别[女性]）评分在预测AF事件发生方面进行了测试。总共有471，446人（年龄>= 20岁）接受了研究，有1，924，975人年的经验。我们确定了921例房颤患者（62%为男性，平均年龄62岁）。年龄≥ 20岁的受试者中AF事件的患病率为0.2/100人，总体AF发生率为0.05/100人-年。在11年的时间里，AF的患病率增加了20倍，而AF相关的卒中增加了13倍。在中国成年人中，房颤的终生风险约为五分之一，并且随着年龄的增长而增加。CHA（2）DS（2）-VASc评分在预测中国人群中AF事件风险方面上级CHADS（2）评分（DeLong检验，Z = 6.621，P <0.001）。结论：在中国西南地区，AF负担以及AF相关卒中的风险在过去11年中显著增加。房颤及其并发症的公共卫生负担在高龄患者中最大，鉴于这种常见心律失常的全球负担，对医疗保健系统具有重大影响。
BACKGROUND: Much of the epidemiology of atrial fibrillation (AF) is based on data from Western populations. Despite the huge population of Asia, data on the clinical epidemiology of AF in Asian countries are limited. The current study aimed to investigate the prevalence and incidence of newly diagnosed (ie, incident) AF, as well as lifetime risk, in China and to determine the clinical risk factors contributing to its development.METHODS: Using a medical insurance database involving. 10 million individuals for the years 2001 to 2012 in the southwest of China, trends in incident AF were calculated using Kaplan-Meier analysis and Cox regression. The usefulness of the CHADS(2) (congestive heart failure, hypertension, age, diabetes, stroke [doubled]) and CHA(2)DS(2)-VASc (congestive heart failure, hypertension, age >= 75 [doubled], diabetes, stroke [doubled], vascular disease, age 65-74, and sex category [female]) scores was tested in predicting the occurrence of incident AF.RESULTS: A total of 471,446 individuals (aged >= 20 years) were studied, with 1,924,975 person years of experience. We identified 921 patients with incident AF (62% male; mean age, 62 years). The prevalence of incident AF in subjects aged >= 20 years was 0.2 per 100 people, with an incidence of AF of 0.05 per 100 person-years overall. Over an 11-year period, the prevalence of AF increased 20-fold, whereas AF-related stroke increased 13-fold. The lifetime risk of AF was approximately one in five among Chinese adults, and it increased with advancing age. The CHA(2)DS(2)-VASc score was superior to the CHADS(2) score in predicting the risk of incident AF in our Chinese population (DeLong test, Z = 6.621, P < .001).CONCLUSIONS: The AF burden, as well as the risk of AF-related stroke, has increased significantly over the past 11 years in the southwest of China. The public health burden of AF and its complications are greatest in the very elderly, with major implications for health-care systems given the global burden of this common arrhythmia.