Copyright © 1999 by the European Society of Cardiology.
Decrease in mortality in patients with a hospital diagnosis of atrial fibrillation in Denmark during the period 1980–1993
a The Department of Cardiology, Amtssygehuset, Aarhus University Hospital, Aarhus
b Centre for Research in Health & Social Statistics, Copenhagen, Denmark
revised April 27, 1999; accepted April 28, 1999
Abstract
Background Atrial fibrillation is associated with increased mortality. We hypothesized that the death rate in atrial fibrillation patients in Denmark has diminished during the period 1980–1993.
Methods In a random sample of half of the Danish population, 30330 patients were found to have a diagnosis of incident atrial fibrillation in the Danish National Hospital Discharge Register 1980–1993. Information on previous and concomitant cardiovascular and metabolic diseases during the period 1977–1993 was sought in the register. The temporal trend in total and cardiovascular mortality in the cohort of atrial fibrillation patients was analysed.
Results A significant decrease in total and cardiovascular mortality was seen, 12–13% for total mortality and 17–18% for cardiovascular mortality. By adjusting for the decreasing cardiovascular mortality rate in the general population, a decrease in the relative risk of total mortality of 8–13% with time was seen for the atrial fibrillation cohort, compared with the population risk, while no reduction in the relative risk of cardiovascular death was seen.
Conclusion A significant decrease in mortality with calendar period occurred in the cohort of atrial fibrillation patients.
Key Words: Atrial fibrillation, epidemiology, prognosis
f1 Correspondence: Lars Frost, Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, DK-8200 Aarhus N, Denmark.
References
- Benjamin EJ, Levy D, Vaziri SM, D'Agostino RB, Belanger AJ, Wolf PA. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA. 1994;271:840–844
[Abstract/Free Full Text] - Krahn AD, Manfreda J, Tate RB, Mathewson FA, Cuddy TE. The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study. Am J Med. 1995;98:476–484[CrossRef][Web of Science][Medline]
- Psaty BM, Manolio TA, Kuller LH. Incidence of and risk factors for atrial fibrillation in older adults. Circulation. 1997;96:2455–2461
[Abstract/Free Full Text] - Prystowsky EN, Benson DW Jr, Fuster V. Management of patients with atrial fibrillation. A Statement for Healthcare Professionals. From the Subcommittee on Electrocardiography and Electrophysiology, American Heart Association. Circulation. 1996;93:1262–1277
[Free Full Text] - Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22:983–988
[Abstract/Free Full Text] - Petersen P, Boysen G, Godtfredsen J, Andersen ED, Andersen B. Placebo-controlled, randomised trial of warfarin and aspirin for prevention of thromboembolic complications in chronic atrial fibrillation. The Copenhagen AFASAK study. Lancet. 1989;1:175–179[Web of Science][Medline]
- Circulation. 1991;84:527–539
[Abstract/Free Full Text] - N Engl J Med. 1990;323:1505–1511[Abstract]
- Connolly SJ, Laupacis A, Gent M, Roberts RS, Cairns JA, Joyner C. Canadian Atrial Fibrillation Anticoagulation (CAFA) Study. J Am Coll Cardiol. 1991;18:349–355[Abstract]
- Ezekowitz MD, Bridgers SL, James KE. Warfarin in the prevention of stroke associated with nonrheumatic atrial fibrillation. Veterans Affairs Stroke Prevention in Nonrheumatic Atrial Fibrillation Investigators. N Engl J Med. 1992;327:1406–1412[Abstract]
- Anonymous. Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation. Analysis of pooled data from five randomized controlled trials. Arch Intern Med. 1994;154:1449–1457
[Abstract/Free Full Text] - Wolf PA, Mitchell JB, Baker CS, Kannel WB, D'Agostino RB. Impact of atrial fibrillation on mortality, stroke, and medical costs. Arch Intern Med. 1998;158:229–234
[Abstract/Free Full Text] - Kannel WB, Abbott RD, Savage DD, McNamara PM. Epidemiologic features of chronic atrial fibrillation. The Framingham Study. N Engl J Med. 1982;306:1018–1022[Abstract]
- Lake FR, Cullen KJ, de Klerk NH, McCall MG, Rosman DL. Atrial fibrillation and mortality in an elderly population. Aust N Z J Med. 1989;19:321–326[Web of Science][Medline]
- Benjamin EJ, Wolf PA, D'Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death. The Framingham Heart Study. Circulation. 1998;98:946–952
[Abstract/Free Full Text] - Breslow NE, Day NE. Statististical methods in cancer research. Vol. II: the design and analysis of cohort studies. Lyon: IARC; 1987.
- Wolf PA, Benjamin EJ, Belanger AJ, Kannel WB, Levy D, D'Agostino RB. Secular trends in the prevalence of atrial fibrillation: The Framingham Study. Am Heart J. 1996;131:790–795[CrossRef][Web of Science][Medline]
- Godtfredsen, J, Atrial fibrillation. Etiology, course and prognosis, Copenhagen, Munskgaard, 1975
- Osler M, Sørensen TIA, Sørensen S. Trends in mortality, incidence and case fatality of ischaemic heart disease in Denmark, 1982–1992. Int J Epidemiol. 1996;25:1154–1161
[Abstract/Free Full Text] - Rothman KJ. Modern epidemiology. Boston: Little, Brown and Company; 1986.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  I. E. Christophersen, L. S. Ravn, E. Budtz-Joergensen, A. Skytthe, S. Haunsoe, J. H. Svendsen, and K. Christensen Familial Aggregation of Atrial Fibrillation: A Study in Danish Twins Circ Arrhythm Electrophysiol, August 1, 2009; 2(4): 378 - 383. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Miyasaka, M. E. Barnes, K. R. Bailey, S. S. Cha, B. J. Gersh, J. B. Seward, and T. S.M. Tsang Mortality Trends in Patients Diagnosed With First Atrial Fibrillation: A 21-Year Community-Based Study J. Am. Coll. Cardiol., March 6, 2007; 49(9): 986 - 992. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Frost, P. Vestergaard, and L. Mosekilde Hyperthyroidism and Risk of Atrial Fibrillation or Flutter: A Population-Based Study Arch Intern Med, August 9, 2004; 164(15): 1675 - 1678. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Stewart, N Murphy, A Walker, A McGuire, and J J V McMurray Cost of an emerging epidemic: an economic analysis of atrial fibrillation in the UK Heart, March 1, 2004; 90(3): 286 - 292. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. A. Wattigney, G. A. Mensah, and J. B. Croft Increasing Trends in Hospitalization for Atrial Fibrillation in the United States, 1985 Through 1999: Implications for Primary Prevention Circulation, August 12, 2003; 108(6): 711 - 716. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. D.M Engelmann and S. Pehrson Quality of life in nonpharmacologic treatment of atrial fibrillation Eur. Heart J., August 1, 2003; 24(15): 1387 - 1400. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. A. Wattigney, G. A. Mensah, and J. B. Croft Increased Atrial Fibrillation Mortality: United States, 1980-1998 Am. J. Epidemiol., May 1, 2002; 155(9): 819 - 826. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Stewart, K. MacIntyre, M.M.C. MacLeod, A.E.M. Bailey, S. Capewell, and J.J.V. McMurray Trends in hospital activity, morbidity and case fatality related to atrial fibrillation in Scotland, 1986-1996 Eur. Heart J., April 2, 2001; 22(8): 693 - 701. [Abstract] [PDF]
|
|
|
|
|
|
L. Frost, G. Engholm, S. Johnsen, H. Moller, E. W. Henneberg, and S. Husted Incident Thromboembolism in the Aorta and the Renal, Mesenteric, Pelvic, and Extremity Arteries After Discharge From the Hospital With a Diagnosis of Atrial Fibrillation Arch Intern Med, January 22, 2001; 161(2): 272 - 276. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.S. Alpert Atrial fibrillation: a growth industry in the 21st century Eur. Heart J., August 1, 2000; 21(15): 1207 - 1208. [PDF]
|
|
|
|
|
|
G.Y.H. Lip Atrial fibrillation and mortality Eur. Heart J., November 1, 1999; 20(21): 1525 - 1527. [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||