Epidemiology, economic burden and mortality of atrial fibrillation in a region with very high life expectancy
a contemporary, population-based analysis in Catalonia.
The high prevalence of atrial fibrillation (AF) is a public-health challenge, especially in ageing societies. This retrospective population-based study used the Catalan public health system database (8 million people, 2019-2023). Age-standardised AF prevalence remained stable at 2.5%, while incidence fell slightly (from 3.8 to 3.6 per 1,000). The 2023 AF population had a median age of 77.6 years and a high comorbidity burden: heart failure (37.6%), obesity (33.8%) and coronary disease (26.7%). Low socioeconomic status was associated with higher AF prevalence. AF was modestly associated with all-cause mortality (OR 1.25), and its healthcare costs were estimated at 2% of the annual Catalan health budget. In a high-life-expectancy region, AF prevalence thus appears to be plateauing, with a high disease burden and substantial economic impact.
Background
The high prevalence of atrial fibrillation (AF) and its association with cardiovascular (CV) outcomes represent a challenge for public health systems, particularly in ageing societies.
Objectives
The aim of this study was to conduct a thorough epidemiological analysis of AF in Catalonia, a region with high life expectancy, from prevalence and incidence to mortality and associated healthcare resource use.
Methods
This retrospective population-based study used the database of the Catalan public health system, including 8 million people. AF prevalence, incidence and mortality were assessed from 2019 to 2023. Comorbidities and healthcare resource expenditure in prevalent AF cases were assessed for the year 2023. Analyses were adjusted for age, sex, income and comorbidities.
Results
During the 5-year study period, the age-standardised prevalence of AF remained stable (2.5%), while incidence decreased, from 3.8‰ to 3.6‰. In 2023, the AF population had a median age of 77.6 years and had a high burden of comorbidities including heart failure (37.6%), obesity (33.8%) and coronary heart disease (26.7%). Low socioeconomic status was associated with higher AF prevalence. There was a modest association between AF and all-cause mortality (OR 1.25). The healthcare resource use associated with AF was estimated to account for 2% of the annual Catalan health budget.
Conclusions
In Catalonia, AF prevalence has plateaued over the last 5 years and the incidence has decreased. Patients with AF have advanced mean age and a high burden of comorbidities. AF is associated with a modest increase in all-cause mortality, and its management represents 2% of the Catalan health budget.
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