Arrhythmias & electrophysiology
Role of primary and secondary care data in atrial fibrillation ascertainment: impact on risk factor associations, patient management, and mortality in UK Biobank
Authors' conclusion
Integration of data from primary care with that from hospital records has a substantial impact on AF ascertainment, identifying a third more cases than hospital records alone. However, about a third of AF cases recorded in hospital were not present in the primary care records, and these cases had lower rates of anticoagulation, as well as higher mortality from both cardiovascular and non-cardiovascular causes.
Study context
- Population
- UK Biobank participants with hospital admissions, diagnoses, and procedures (HADP) and primary care (PC) records (to 2016); incident atrial fibrillation (AF) cases7,136 incident AF cases
- Participants
- 230,000 participants
- Exposure
- AF ascertainment by data source: PC-only vs PC + HADP vs HADP only (HADP-only)
- Outcome
- Proportion of incident AF cases by ascertainment source
- Follow-up
- 7 years median
Main finding
As reported in the abstract
- Median lag between ascertainment in PC and subsequently in HADP
- 1.3 years
Observational data: associations, not effects.
Further findings
Subsequent anticoagulation
Death (events per 1000 person-years)
- Subsequent anticoagulation: P < 0.0001
- Death (events per 1000 person-years): P < 0.0001
Baseline characteristics
- Comparable baseline demographics across groups; higher prevalence of cardiometabolic comorbidities in HADP-only
Original publication
Role of primary and secondary care data in atrial fibrillation ascertainment: impact on risk factor associations, patient management, and mortality in UK Biobank. Europace. Published 6 February 2025. doi:10. 1093/ europace/ euae291
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