10-year nationwide trends of the incidence, prevalence, and adverse outcomes of non-valvular atrial fibrillation nationwide health insurance data covering the entire Korean population

Daehoon Kim, Pil Sung Yang, Eunsun Jang, Hee Tae Yu, Tae Hoon Kim, Jae Sun Uhm, Jong Youn Kim, Hui Nam Pak, Moon Hyoung Lee, Boyoung Joung, Gregory YH Lip

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Abstract

Background: Most data on the clinical epidemiology of atrial fibrillation (AF) are reported from Western populations, and data for Asians are limited. We aimed to investigate the 10-year trends of the prevalence and incidence of non-valvular AF and provide prevalence projections till 2060 in Korea. We also investigated the annual risks of adverse outcomes among patients with AF. Methods: Using the Korean National Health Insurance Service database involving the entire Korean population, a total of 679,416 adults with newly diagnosed AF were identified from 2006 to 2015. The incidence and prevalence of AF and risk of adverse outcomes following AF onset were assessed. Results: The prevalence of AF progressively increased by 2.10-fold from 0.73% in 2006 to 1.53% in 2015. The trend of its incidence was flat with a 10-year overall incidence of 1.77 per 1,000 person-years. The prevalence of AF is expected to reach 5.81% (2,290,591 patients with AF) in 2060. For a decade, the risk of all-cause mortality following AF declined by 30% (adjusted hazard ratio [HR]: 0.70, 95% confidence interval [CI]: 0.68–0.72), heart failure by 52% (adjusted HR: 0.48, 95% CI: 0.44–0.51), and ischemic stroke by 9% (adjusted HR: 0.91, 95% CI: 0.88–0.93). Conclusions: The burden of AF among Asian patients is increasing. Although the overall risks of cardiovascular events and death following AF onset have decreased over a decade, the event rates are still high. Optimized management of any associated comorbidities should be part of the holistic management approach for patients with AF.

Original languageEnglish
Pages (from-to)20-26
Number of pages7
JournalAmerican heart journal
Volume202
DOIs
Publication statusPublished - 2018 Aug

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Health Insurance
Atrial Fibrillation
Incidence
Population
National Health Programs
Confidence Intervals
Korea
Comorbidity
Epidemiology
Heart Failure
Stroke
Databases

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Daehoon ; Yang, Pil Sung ; Jang, Eunsun ; Yu, Hee Tae ; Kim, Tae Hoon ; Uhm, Jae Sun ; Kim, Jong Youn ; Pak, Hui Nam ; Lee, Moon Hyoung ; Joung, Boyoung ; Lip, Gregory YH. / 10-year nationwide trends of the incidence, prevalence, and adverse outcomes of non-valvular atrial fibrillation nationwide health insurance data covering the entire Korean population. In: American heart journal. 2018 ; Vol. 202. pp. 20-26.
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title = "10-year nationwide trends of the incidence, prevalence, and adverse outcomes of non-valvular atrial fibrillation nationwide health insurance data covering the entire Korean population",
abstract = "Background: Most data on the clinical epidemiology of atrial fibrillation (AF) are reported from Western populations, and data for Asians are limited. We aimed to investigate the 10-year trends of the prevalence and incidence of non-valvular AF and provide prevalence projections till 2060 in Korea. We also investigated the annual risks of adverse outcomes among patients with AF. Methods: Using the Korean National Health Insurance Service database involving the entire Korean population, a total of 679,416 adults with newly diagnosed AF were identified from 2006 to 2015. The incidence and prevalence of AF and risk of adverse outcomes following AF onset were assessed. Results: The prevalence of AF progressively increased by 2.10-fold from 0.73{\%} in 2006 to 1.53{\%} in 2015. The trend of its incidence was flat with a 10-year overall incidence of 1.77 per 1,000 person-years. The prevalence of AF is expected to reach 5.81{\%} (2,290,591 patients with AF) in 2060. For a decade, the risk of all-cause mortality following AF declined by 30{\%} (adjusted hazard ratio [HR]: 0.70, 95{\%} confidence interval [CI]: 0.68–0.72), heart failure by 52{\%} (adjusted HR: 0.48, 95{\%} CI: 0.44–0.51), and ischemic stroke by 9{\%} (adjusted HR: 0.91, 95{\%} CI: 0.88–0.93). Conclusions: The burden of AF among Asian patients is increasing. Although the overall risks of cardiovascular events and death following AF onset have decreased over a decade, the event rates are still high. Optimized management of any associated comorbidities should be part of the holistic management approach for patients with AF.",
author = "Daehoon Kim and Yang, {Pil Sung} and Eunsun Jang and Yu, {Hee Tae} and Kim, {Tae Hoon} and Uhm, {Jae Sun} and Kim, {Jong Youn} and Pak, {Hui Nam} and Lee, {Moon Hyoung} and Boyoung Joung and Lip, {Gregory YH}",
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10-year nationwide trends of the incidence, prevalence, and adverse outcomes of non-valvular atrial fibrillation nationwide health insurance data covering the entire Korean population. / Kim, Daehoon; Yang, Pil Sung; Jang, Eunsun; Yu, Hee Tae; Kim, Tae Hoon; Uhm, Jae Sun; Kim, Jong Youn; Pak, Hui Nam; Lee, Moon Hyoung; Joung, Boyoung; Lip, Gregory YH.

In: American heart journal, Vol. 202, 08.2018, p. 20-26.

Research output: Contribution to journalArticle

TY - JOUR

T1 - 10-year nationwide trends of the incidence, prevalence, and adverse outcomes of non-valvular atrial fibrillation nationwide health insurance data covering the entire Korean population

AU - Kim, Daehoon

AU - Yang, Pil Sung

AU - Jang, Eunsun

AU - Yu, Hee Tae

AU - Kim, Tae Hoon

AU - Uhm, Jae Sun

AU - Kim, Jong Youn

AU - Pak, Hui Nam

AU - Lee, Moon Hyoung

AU - Joung, Boyoung

AU - Lip, Gregory YH

PY - 2018/8

Y1 - 2018/8

N2 - Background: Most data on the clinical epidemiology of atrial fibrillation (AF) are reported from Western populations, and data for Asians are limited. We aimed to investigate the 10-year trends of the prevalence and incidence of non-valvular AF and provide prevalence projections till 2060 in Korea. We also investigated the annual risks of adverse outcomes among patients with AF. Methods: Using the Korean National Health Insurance Service database involving the entire Korean population, a total of 679,416 adults with newly diagnosed AF were identified from 2006 to 2015. The incidence and prevalence of AF and risk of adverse outcomes following AF onset were assessed. Results: The prevalence of AF progressively increased by 2.10-fold from 0.73% in 2006 to 1.53% in 2015. The trend of its incidence was flat with a 10-year overall incidence of 1.77 per 1,000 person-years. The prevalence of AF is expected to reach 5.81% (2,290,591 patients with AF) in 2060. For a decade, the risk of all-cause mortality following AF declined by 30% (adjusted hazard ratio [HR]: 0.70, 95% confidence interval [CI]: 0.68–0.72), heart failure by 52% (adjusted HR: 0.48, 95% CI: 0.44–0.51), and ischemic stroke by 9% (adjusted HR: 0.91, 95% CI: 0.88–0.93). Conclusions: The burden of AF among Asian patients is increasing. Although the overall risks of cardiovascular events and death following AF onset have decreased over a decade, the event rates are still high. Optimized management of any associated comorbidities should be part of the holistic management approach for patients with AF.

AB - Background: Most data on the clinical epidemiology of atrial fibrillation (AF) are reported from Western populations, and data for Asians are limited. We aimed to investigate the 10-year trends of the prevalence and incidence of non-valvular AF and provide prevalence projections till 2060 in Korea. We also investigated the annual risks of adverse outcomes among patients with AF. Methods: Using the Korean National Health Insurance Service database involving the entire Korean population, a total of 679,416 adults with newly diagnosed AF were identified from 2006 to 2015. The incidence and prevalence of AF and risk of adverse outcomes following AF onset were assessed. Results: The prevalence of AF progressively increased by 2.10-fold from 0.73% in 2006 to 1.53% in 2015. The trend of its incidence was flat with a 10-year overall incidence of 1.77 per 1,000 person-years. The prevalence of AF is expected to reach 5.81% (2,290,591 patients with AF) in 2060. For a decade, the risk of all-cause mortality following AF declined by 30% (adjusted hazard ratio [HR]: 0.70, 95% confidence interval [CI]: 0.68–0.72), heart failure by 52% (adjusted HR: 0.48, 95% CI: 0.44–0.51), and ischemic stroke by 9% (adjusted HR: 0.91, 95% CI: 0.88–0.93). Conclusions: The burden of AF among Asian patients is increasing. Although the overall risks of cardiovascular events and death following AF onset have decreased over a decade, the event rates are still high. Optimized management of any associated comorbidities should be part of the holistic management approach for patients with AF.

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