Arrhythmias & electrophysiologyCohort study
Life expectancy, loss-of-life expectancy, medical expenditures, and trends for atrial fibrillation: A population cohort over 20 years
- retrospective cohort study
Authors' conclusion
AF is associated with substantial LoLE, with the greatest burden observed in younger patients because of their extended lifetime exposure to the condition. Significant outcome improvements between 2011 and 2021 coincide with expanded anticoagulant use and evolving treatment strategies, although the contributions of individual therapeutic advances cannot be isolated in this observational design.
Study context
- Population
- Patients with incident atrial fibrillation (AF) from Taiwan's National Health Insurance Research Database, 2000 to 2021patients with incident AF
- Participants
- 619,147 patients
- Exposure
- Loss-of-LE (LoLE) determined by comparison with the matched general population; diagnosis period (2000-2010 vs 2011-2021)
Main finding
As reported in the abstract
Life expectancy (LE) and LoLE significantly decreased from the youngest group (age 20-39 years) to the oldest group (age 85-99 years)
P < .001
Observational data: associations, not effects.
Further findings
| Outcome | LoLE reduction (years) (95% CI) | P value |
|---|---|---|
| LoLE reduction, patients aged <65 years (2011-2021 vs 2000-2010) · greatest improvement; reduction in LoLE | 2.94 (−3.97 to −1.91) | P < 0.001 |
LE and LoLE by sex
- Females had longer LE but greater LoLE than males
Mortality rate, youngest subgroup vs matched general population
- fold higher mortality rate than the matched general population
- 19.63
CHA2DS2-VASc score correlation with mortality rate and LE
- Correlation with mortality rate
- r = 0.988, P < .001
- Correlation with LE
- r = −0.931, P < .001
- Peak LoLE at score 1
Mortality rates, LE, LoLE and medical costs by diagnosis period
- Outcomes, including mortality rates, LE, and LoLE, significantly improved in 2011-2021, whereas medical costs increased
Original publication
Summarised from the published abstract; every number is checked against it