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. 2023 Jul 11;23(1):345.
doi: 10.1186/s12872-023-03375-9.

Global, regional, and national burden of heart failure associated with atrial fibrillation

Sanjeewa Kularatna  1 , Amarzaya Jadambaa  1   2 , Sumudu Hewage  3 , David Brain  1 , Steven McPhail  1 , William Parsonage  1   4
Affiliations

Global, regional, and national burden of heart failure associated with atrial fibrillation

Sanjeewa Kularatna et al. BMC Cardiovasc Disord. .

Abstract

Background: Heart failure is a leading cause of mortality and morbidity worldwide, and Atrial fibrillation (AF) is among many modifiable risk factors for heart failure. No estimates are available on the magnitude of the burden of heart failure associated with AF, and this study estimated the global, regional, and national burdens associated with AF.

Methods: We used the comparative risk assessment method to estimate the disease burden in terms of prevalence and years lived with disability (YLD). The population-attributable fraction for heart failure and AF was calculated from prevalence estimates of AF and the recalculated relative risks of heart failure associated with AF from a systematic review summarising the longitudinal association between AF and outcomes. The burden of heart failure was retrieved from the Global Burden of Disease database.

Results: Globally, 2.6% (95% uncertainty interval 1.3 to 4.7%) of the burden of heart failure is associated with AF. This was 1.5 (95% UI 0.6 to 3.2) million people in 2019, a 49.8% increase from 1990. The highest prevalence was from South-East Asia, East Asia and Oceania. The highest YLD was estimated for Central Europe, Eastern Europe and Central Asia. High-income countries showed a sharp decline in the age standardised prevalence and YLD rates from 1990 to 2019.

Conclusion: The burden of heart failure associated with AF has increased substantially over the past two decades despite the advances in AF management. However, falling prevalence and YLD rates of heart failure associated with AF in high-income countries over time indicate that reducing this burden is possible.

Keywords: Atrial fibrillation; Global burden; Heart failure; National burden; Population attributable fraction; Regional burden.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Global YLD (a) absolute counts and (b) rates for heart failure associated with atrial fibrillation, by age group, by sex, for 2019
Fig. 2
Fig. 2
Age standardised prevalence and YLD rates per 100,000 population due to heart failure associated with atrial fibrillation for both sexes, by GBD super region, for 2019
Fig. 3
Fig. 3
Time trends for age-standardised (a) prevalence and (b) YLD rates for heart failure associated with atrial fibrillation per 100,000 population in GBD super regions, for both sexes and all ages, 1990–2019. YLD- years lived with disability, GBD—Global Burden of Diseases, Injuries, and Risk Factors Study
Fig. 4
Fig. 4
Age-standardised YLD rates for heart failure associated with atrial fibrillation per 100,000 population, for both sexes, by country, for 2019
See this image and copyright information in PMC

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References

    1. Braunwald E. cardiovascular medicine at the turn of the millennium: triumphs, concerns, and opportunities. N Engl J Med. 1997;337(19):1360–1369. doi: 10.1056/NEJM199711063371906. - DOI - PubMed
    1. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2021;42(36):3599–3726. doi: 10.1093/eurheartj/ehab368. - DOI - PubMed
    1. Institute for Health Matrix Evaluation (IHME). GBD Results Seatle, WA; 2020. Available from: http://ghdx.healthdata.org/gbd-results-tool.
    1. Koelling TM, Chen RS, Lubwama RN, L’Italien GJ, Eagle KA. The expanding national burden of heart failure in the United States: the influence of heart failure in women. Am Heart J. 2004;147(1):74–78. doi: 10.1016/j.ahj.2003.07.021. - DOI - PubMed
    1. Rosamond W, Flegal K, Friday G, Furie K, Go A, Greenlund K, et al. Heart disease and stroke statistics—2007 update. Circulation. 2007;115(5):e69–e171. doi: 10.1161/CIRCULATIONAHA.106.179918. - DOI - PubMed

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