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Worldwide Epidemiology of Atrial Fibrillation: A Global Burden of Disease 2010 Study
Study Questions:
What is the global burden of atrial fibrillation (AF)?
Methods:
The investigators systematically reviewed population-based studies of AF published between 1980 and 2010, from the 21 Global Burden of Disease (GBD) regions to estimate global/regional prevalence, incidence, as well as morbidity and mortality related to AF (DisModMR software).
Results:
Of 377 potential studies identified, 184 met prespecified eligibility criteria. The estimated number of individuals with AF globally in 2010 was 33.5 million (20.9 million males [uncertainty interval (UI), 19.5-22.2 million) and 12.6 million females [UI, 12.0-13.7 million]). Burden associated with AF, measured as disability adjusted life-years, increased by 18.8% (UI, 15.8-19.3) in males and 18.9% (UI, 15.8-23.5) in females, from 1990 to 2010. In 1990, the estimated age-adjusted prevalence rates of AF (per 100,000 population) were 569.5 in males (95% UI, 532.8-612.7) and 359.9 in females (UI, 334.7-392.6); the estimated age-adjusted incidence rates were 60.7/100,000 person-years in males (UI, 49.2-78.5) and 43.8 in females (UI, 35.9-55.0). In 2010, the prevalence rate increased to 596.2 (UI, 558.4-636.7) in males and 373.1 (UI, 347.9-402.2) in females; incidence rate increased to 77.5 (UI, 65.2-95.4) in males and 59.5 (UI, 49.9-74.9) in females. Mortality associated with AF was higher in females, and increased by two-fold (UI, 2.0-2.2) and 1.9-fold (UI, 1.8-2.0) in males and females, respectively, from 1990 to 2010.
Conclusions:
The authors concluded that these findings provide evidence of progressive increases in overall burden, incidence, prevalence, and AF-associated mortality between 1990 and 2010.
Perspective:
This systematic review of the current worldwide epidemiological data on AF confirms the emergence of AF as a global epidemic, with significant and progressive effects on estimated disability and mortality. Furthermore, there were specific differences identified based on age and GBD region that are likely to have significant implications for global public health. The evidence for geographic variation in AF burden, especially in developing versus developed nations, suggests that systematic, global surveillance of AF is required to formulate effective region-specific prevention and treatment strategies.
Keywords: Uncertainty, Prevalence, Incidence, Morbidity, Developed Countries, Software, Cost of Illness, Quality-Adjusted Life Years
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