Young-Kwan Kim, So-Ryoung Lee, Eue-Keun Choi, Hyun Jin Ahn, Nan Young Bae, Kyung-Yeon Lee, JungMin Choi, Hyo-Jeong Ahn, Soonil Kwon, Kyungdo Han, Seil Oh, Gregory Y H Lip
{"title":"根据流行心房颤动的各种原因导致的死亡风险：一项基于全国人群的研究。","authors":"Young-Kwan Kim, So-Ryoung Lee, Eue-Keun Choi, Hyun Jin Ahn, Nan Young Bae, Kyung-Yeon Lee, JungMin Choi, Hyo-Jeong Ahn, Soonil Kwon, Kyungdo Han, Seil Oh, Gregory Y H Lip","doi":"10.3346/jkms.2024.39.e306","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is associated with increased risks of adverse events including stroke and all-cause death. Understanding the pattern of causes of death (COD) with the relative risks in patients with AF compared to the non-AF population is essential in planning optimal care for patients with AF. We aimed to analyze the COD and its relative risks in patients with AF, using a nationwide population-based cohort.</p><p><strong>Methods: </strong>Using the Korean nationwide claims database, people aged 40 or older who received health examinations in 2009 were included if they had no missing values (n = 6,877,929). In total the study included 40,585 people with AF and 6,837,344 without AF. COD was defined by International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnostic codes. Comparison between the AF and non-AF groups was performed with Multivariate Cox proportional regression model.</p><p><strong>Results: </strong>In the AF group, cardiovascular diseases were the most common COD, causing 39.8% of all deaths, compared with 19.0% for non-AF subjects. The AF group was associated with a higher risk of death from cardiovascular and cerebrovascular diseases by almost 3-fold than the matched non-AF group (hazard ratios [HR], 3.082; 95% confidence intervals [CIs], 2.963-3.205 for cardiovascular diseases; HR, 2.981; 95% CI, 2.799-3.175 for cerebrovascular diseases, all <i>P</i> < 0.001). Among patients with AF, the risks of all-cause, cardiovascular, and cerebrovascular death were well-stratified by CHA₂DS₂-VASc scores. The risk of cerebrovascular death was 11 times higher among patients with a CHA₂DS₂-VASc score ≥ 7.</p><p><strong>Conclusion: </strong>Compared to non-AF individuals, patients with AF had a higher risk of death from cardiovascular and cerebrovascular diseases, and the mortality risks were well-stratified by the CHA₂DS₂-VASc score. Integrated care management of cardiovascular and cerebrovascular diseases for patients with AF might help mitigate mortality.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"39 47","pages":"e306"},"PeriodicalIF":3.0000,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628238/pdf/","citationCount":"0","resultStr":"{\"title\":\"Risk of Death From Various Causes According to Prevalent Atrial Fibrillation: A Nationwide Population-Based Study.\",\"authors\":\"Young-Kwan Kim, So-Ryoung Lee, Eue-Keun Choi, Hyun Jin Ahn, Nan Young Bae, Kyung-Yeon Lee, JungMin Choi, Hyo-Jeong Ahn, Soonil Kwon, Kyungdo Han, Seil Oh, Gregory Y H Lip\",\"doi\":\"10.3346/jkms.2024.39.e306\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Atrial fibrillation (AF) is associated with increased risks of adverse events including stroke and all-cause death. Understanding the pattern of causes of death (COD) with the relative risks in patients with AF compared to the non-AF population is essential in planning optimal care for patients with AF. We aimed to analyze the COD and its relative risks in patients with AF, using a nationwide population-based cohort.</p><p><strong>Methods: </strong>Using the Korean nationwide claims database, people aged 40 or older who received health examinations in 2009 were included if they had no missing values (n = 6,877,929). In total the study included 40,585 people with AF and 6,837,344 without AF. COD was defined by International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnostic codes. Comparison between the AF and non-AF groups was performed with Multivariate Cox proportional regression model.</p><p><strong>Results: </strong>In the AF group, cardiovascular diseases were the most common COD, causing 39.8% of all deaths, compared with 19.0% for non-AF subjects. The AF group was associated with a higher risk of death from cardiovascular and cerebrovascular diseases by almost 3-fold than the matched non-AF group (hazard ratios [HR], 3.082; 95% confidence intervals [CIs], 2.963-3.205 for cardiovascular diseases; HR, 2.981; 95% CI, 2.799-3.175 for cerebrovascular diseases, all <i>P</i> < 0.001). Among patients with AF, the risks of all-cause, cardiovascular, and cerebrovascular death were well-stratified by CHA₂DS₂-VASc scores. The risk of cerebrovascular death was 11 times higher among patients with a CHA₂DS₂-VASc score ≥ 7.</p><p><strong>Conclusion: </strong>Compared to non-AF individuals, patients with AF had a higher risk of death from cardiovascular and cerebrovascular diseases, and the mortality risks were well-stratified by the CHA₂DS₂-VASc score. Integrated care management of cardiovascular and cerebrovascular diseases for patients with AF might help mitigate mortality.</p>\",\"PeriodicalId\":16249,\"journal\":{\"name\":\"Journal of Korean Medical Science\",\"volume\":\"39 47\",\"pages\":\"e306\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-12-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628238/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Korean Medical Science\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3346/jkms.2024.39.e306\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Korean Medical Science","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3346/jkms.2024.39.e306","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Risk of Death From Various Causes According to Prevalent Atrial Fibrillation: A Nationwide Population-Based Study.
Background: Atrial fibrillation (AF) is associated with increased risks of adverse events including stroke and all-cause death. Understanding the pattern of causes of death (COD) with the relative risks in patients with AF compared to the non-AF population is essential in planning optimal care for patients with AF. We aimed to analyze the COD and its relative risks in patients with AF, using a nationwide population-based cohort.
Methods: Using the Korean nationwide claims database, people aged 40 or older who received health examinations in 2009 were included if they had no missing values (n = 6,877,929). In total the study included 40,585 people with AF and 6,837,344 without AF. COD was defined by International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnostic codes. Comparison between the AF and non-AF groups was performed with Multivariate Cox proportional regression model.
Results: In the AF group, cardiovascular diseases were the most common COD, causing 39.8% of all deaths, compared with 19.0% for non-AF subjects. The AF group was associated with a higher risk of death from cardiovascular and cerebrovascular diseases by almost 3-fold than the matched non-AF group (hazard ratios [HR], 3.082; 95% confidence intervals [CIs], 2.963-3.205 for cardiovascular diseases; HR, 2.981; 95% CI, 2.799-3.175 for cerebrovascular diseases, all P < 0.001). Among patients with AF, the risks of all-cause, cardiovascular, and cerebrovascular death were well-stratified by CHA₂DS₂-VASc scores. The risk of cerebrovascular death was 11 times higher among patients with a CHA₂DS₂-VASc score ≥ 7.
Conclusion: Compared to non-AF individuals, patients with AF had a higher risk of death from cardiovascular and cerebrovascular diseases, and the mortality risks were well-stratified by the CHA₂DS₂-VASc score. Integrated care management of cardiovascular and cerebrovascular diseases for patients with AF might help mitigate mortality.
期刊介绍：
The Journal of Korean Medical Science (JKMS) is an international, peer-reviewed Open Access journal of medicine published weekly in English. The Journal’s publisher is the Korean Academy of Medical Sciences (KAMS), Korean Medical Association (KMA). JKMS aims to publish evidence-based, scientific research articles from various disciplines of the medical sciences. The Journal welcomes articles of general interest to medical researchers especially when they contain original information. Articles on the clinical evaluation of drugs and other therapies, epidemiologic studies of the general population, studies on pathogenic organisms and toxic materials, and the toxicities and adverse effects of therapeutics are welcome.
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