Abstract：
OBJECTIVE: We aimed to investigate temporal trends in all-cause mortality, heart failure (HF) hospitalisation, and stroke from 1997 to 2018 in patients diagnosed with both HF and atrial fibrillation (AF).
RESULTS: From Danish nationwide registers, we identified 152 059 patients with new-onset HF between 1997 and 2018. Patients were grouped according to year of new-onset HF and AF-status: Prevalent AF (n = 34 734), New-onset AF (n = 12 691), and No AF (n = 104 634). Median age decreased from 76 to 73 years between 1997 and 2018. The proportion of patients with prevalent or new-onset AF increased from 24.7% (n = 9256) to 35.8% (n = 14 970). Five-year risk of all-cause mortality went from 69.1% (CI: 67.9%-70.2%) to 51.3% (CI: 49.9%-52.7%), 62.3% (CI: 60.5%-64.4%) to 43.0% (CI: 40.5%-45.5%), and 61.9% (CI: 61.3%-62.4%) to 36.7% (CI: 35.9%-37.6%) for the Prevalent AF, New-onset AF and No AF-group, respectively. Minimal changes were observed in the risk of HF-hospitalisation. Five-year stroke risk decreased from 8.5% (CI: 7.8%-9.1%) to 5.0% (CI: 4.4%-5.5%) for the prevalent AF group, 8.2% (CI: 7.2%-9.2%) to 4.6% (CI: 3.7%-5.5%) for new-onset AF, and 6.3% (CI: 6.1%-6.6%) to 4.9% (CI: 4.6%-5.3%) for the No AF group. Simultaneously, anticoagulant therapy increased for patients with prevalent (from 42.7% to 93.1%) and new-onset AF (from 41.9% to 92.5%).
CONCLUSIONS: From 1997 to 2018, we observed an increase in patients with HF and co-existing AF. Mortality decreased for all patients, regardless of AF-status. Anticoagulation therapy increased, and stroke risk for patients with AF was reduced to a similar level as patients without AF in 2013-2018.
RESULTS: From Danish nationwide registers, we identified 152 059 patients with new-onset HF between 1997 and 2018. Patients were grouped according to year of new-onset HF and AF-status: Prevalent AF (n = 34 734), New-onset AF (n = 12 691), and No AF (n = 104 634). Median age decreased from 76 to 73 years between 1997 and 2018. The proportion of patients with prevalent or new-onset AF increased from 24.7% (n = 9256) to 35.8% (n = 14 970). Five-year risk of all-cause mortality went from 69.1% (CI: 67.9%-70.2%) to 51.3% (CI: 49.9%-52.7%), 62.3% (CI: 60.5%-64.4%) to 43.0% (CI: 40.5%-45.5%), and 61.9% (CI: 61.3%-62.4%) to 36.7% (CI: 35.9%-37.6%) for the Prevalent AF, New-onset AF and No AF-group, respectively. Minimal changes were observed in the risk of HF-hospitalisation. Five-year stroke risk decreased from 8.5% (CI: 7.8%-9.1%) to 5.0% (CI: 4.4%-5.5%) for the prevalent AF group, 8.2% (CI: 7.2%-9.2%) to 4.6% (CI: 3.7%-5.5%) for new-onset AF, and 6.3% (CI: 6.1%-6.6%) to 4.9% (CI: 4.6%-5.3%) for the No AF group. Simultaneously, anticoagulant therapy increased for patients with prevalent (from 42.7% to 93.1%) and new-onset AF (from 41.9% to 92.5%).
CONCLUSIONS: From 1997 to 2018, we observed an increase in patients with HF and co-existing AF. Mortality decreased for all patients, regardless of AF-status. Anticoagulation therapy increased, and stroke risk for patients with AF was reduced to a similar level as patients without AF in 2013-2018.
摘要：
目的：我们旨在调查全因死亡率的时间趋势，心力衰竭（HF）住院，1997年至2018年诊断为心力衰竭和心房颤动（AF）的患者的卒中。
结果：来自丹麦全国范围的登记册，我们在1997年至2018年期间确认了152.059例新发HF患者.根据新发HF和AF状态的年份对患者进行分组：普遍AF（n=34.734），新发房颤（n=12.691），无AF(n=104.634)。在1997年至2018年期间，中位年龄从76岁下降到73岁。流行或新发房颤患者的比例从24.7%(n=9256)增加到35.8%(n=14.970)。全因死亡率的五年风险从69.1%（CI：67.9%-70.2%）上升到51.3%（CI：49.9%-52.7%），62.3%（CI：60.5%-64.4%）至43.0%（CI：40.5%-45.5%），和61.9%（CI：61.3%-62.4%）至36.7%（CI：35.9%-37.6%），新发房颤和无房颤组,分别。观察到HF住院风险的变化很小。房颤组的五年卒中风险从8.5%(CI:7.8%-9.1%)下降到5.0%(CI:4.4%-5.5%),新发房颤的8.2%（CI：7.2%-9.2%）至4.6%（CI：3.7%-5.5%），无房颤组6.3%(CI:6.1%-6.6%)至4.9%(CI:4.6%-5.3%)。同时,对于流行(从42.7%到93.1%)和新发房颤(从41.9%到92.5%)的患者,抗凝治疗增加.
结论：从1997年到2018年，我们观察到HF和并存的AF患者有所增加。所有患者的死亡率都下降了，无论AF状态如何。抗凝治疗增加，2013-2018年,房颤患者的卒中风险降低至与无房颤患者相似的水平.
结果：来自丹麦全国范围的登记册，我们在1997年至2018年期间确认了152.059例新发HF患者.根据新发HF和AF状态的年份对患者进行分组：普遍AF（n=34.734），新发房颤（n=12.691），无AF(n=104.634)。在1997年至2018年期间，中位年龄从76岁下降到73岁。流行或新发房颤患者的比例从24.7%(n=9256)增加到35.8%(n=14.970)。全因死亡率的五年风险从69.1%（CI：67.9%-70.2%）上升到51.3%（CI：49.9%-52.7%），62.3%（CI：60.5%-64.4%）至43.0%（CI：40.5%-45.5%），和61.9%（CI：61.3%-62.4%）至36.7%（CI：35.9%-37.6%），新发房颤和无房颤组,分别。观察到HF住院风险的变化很小。房颤组的五年卒中风险从8.5%(CI:7.8%-9.1%)下降到5.0%(CI:4.4%-5.5%),新发房颤的8.2%（CI：7.2%-9.2%）至4.6%（CI：3.7%-5.5%），无房颤组6.3%(CI:6.1%-6.6%)至4.9%(CI:4.6%-5.3%)。同时,对于流行(从42.7%到93.1%)和新发房颤(从41.9%到92.5%)的患者,抗凝治疗增加.
结论：从1997年到2018年，我们观察到HF和并存的AF患者有所增加。所有患者的死亡率都下降了，无论AF状态如何。抗凝治疗增加，2013-2018年,房颤患者的卒中风险降低至与无房颤患者相似的水平.
