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

EuropacePublished Prospective cohort study

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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