Trends in the incidence and prevalence of atrial fibrillation and estimated thromboembolic risk using the CHA2DS2-VASc score in the entire Korean population

Abstract

Background: Data on the epidemiology of atrial fibrillation (AF) and temporal trends are not well established in the Korean population. We aimed to estimate the incidence and prevalence of AF in Korea between 2008 and 2015.

Methods: Using the National Health Insurance Service database, we analyzed as a nationwide cohort the entire Korean adult population from 2008 to 2015 (n=41,505,679 in 2015). AF was identified by using diagnostic codes.

Results: During an 8-year period representing 314,311,360 person-years of follow-up, 496,341 individuals were newly diagnosed with AF. The incidence of AF increased to >1.12-fold as follows: from 15.34 to 17.14 per 10,000 person-years (p<0.001). We also found a 1.68-fold increase in the prevalence of AF, from 0.46% in 2008 to 0.67% in 2015 (p<0.001). The incidence and prevalence of AF increased with advancing age. The median age of the AF patients increased from 68 to 71years (p<0.001). The prevalence of diabetes and heart failure in AF subjects increased (p<0.001). The percentage of patients with a CHA₂DS₂-VASc score of ≥2, who were strongly recommended for anticoagulation treatment, increased from 80.2% to 86.8% (p<0.001).

Conclusion: The incidence and prevalence of AF gradually increased from 2008 to 2015. The proportion of AF patients who were candidates for anticoagulation therapy also significantly increased owing to population aging and increasing comorbidities (i.e., heart failure and diabetes). These findings may provide a framework to understand the actual disease burden and establish the optimal management strategy for AF.

Keywords: Anticoagulation; Atrial fibrillation; Incidence; Prevalence; Stroke.