Prevalence and risk of atrial fibrillation in China: A national cross-sectional epidemiological study

Shu, Shi; Tang, Yanhong; Zhao, Qingyan; Yan, Hong; Yu, Bin; Zheng, Qiangsun; Li, Yi‐Gang; Zheng, Liangrong; Yang, Yuan; Zhong, Jian; Xu, Juan; Xu, Jianguo; Chen, Lin; Li, Shufeng; Jiang, Jian; Wang, Jingfeng; Fan, Jin‐Hu; Chen, Minglong; Tang, Baopeng; Li, Wei; Wu, Qiang; Shi, Bei; Zhou, Shenghua; Zhao, Xingsheng; Yin, Yuehui; Zhang, Zheng; Zhong, Guoqiang; Han, Xiao; Liu, Fan; Wu, Ming; Gao, Lianjun; Yang, Bo; Huang, He; Huang, Congxin

doi:10.1016/j.lanwpc.2022.100439

Cited by 45 publications

(35 citation statements)

References 29 publications

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“…Atrial fibrillation (AF) is the most common sustained tachyarrhythmia. Our latest national cross-sectional epidemiological study found the prevalence of AF was 1.6% in the Chinese adult population, which indicates a 146% increase compares with the previous investigation in 2004 ( 1 ). AF has been proved to increased the risk of stroke and extracranial systemic embolism events, and thromboembolic events are associated with increased long-term disability and death ( 2 ).…”

Section: Introductionmentioning

confidence: 49%

Left Atrial Thrombus in Patients With Non-valvular Atrial Fibrillation: A Cross-Sectional Study in China

Shu

Zhao

Liu

et al. 2022

Front. Cardiovasc. Med.

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BackgroundStroke is predominately attributed to left atrial thrombus (LAT) in patients with non-valvular atrial fibrillation (NVAF), however, its detection rate in real clinical practice has been few reported in China.ObjectiveThis study aimed to investigate the prevalence and associated factors of LAT in patients with NVAF in China.MethodsAll adult NVAF patients undergoing transesophageal echocardiography (TEE) in the China Atrial Fibrillation Center database from January 2017 to January 2022 were enrolled in this study. The prevalence of LAT was calculated, and associated factors were identified.ResultsA total of 36,007 NVAF inpatients from 602 hospitals in 30 provinces/autonomous regions/municipalities were included in the final analysis, with a median age of 66 years and 39.4% were female. LAT was present in 1,467 (4.1%) patients overall, 2.7, 5.7, and 6.8% in patients with paroxysmal, persistent, and long-standing persistent AF, respectively. In subgroup analysis, including age ≥ 65 years, CHA2DS2-VASC score ≥ 2, left atrial diameter (LAD) ≥ 50 mm, left ventricular ejection fraction (LVEF) < 50%, and anticoagulation, patients with paroxysmal AF always had the lowest LAT prevalence, followed by patients with persistent and long-standing persistent AF. Patients treated with anticoagulants had less prevalent LAT than those without anticoagulation (2.1 vs. 5.0%, p < 0.001). In multivariate analysis, AF pattern (both persistent AF and long-standing persistent AF), hypertension, chronic heart failure, coronary heart disease, transient ischemic attack/stroke, diabetes mellitus, and LAD (per 5 mm) were associated with an increased prevalence of LAT. However, LVEF (per 5%) and anticoagulation were associated with a reduced prevalence of LAT.ConclusionLAT was found in 4.1% of Chinese adult NVAF inpatients underwent TEE in real-world experience. The prevalence of LAT mainly associated with non-paroxysmal AF, cardiovascular diseases, diabetes mellitus, enlarged left atrium, lower LVEF, and lack of anticoagulation therapy.

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Section: Introductionmentioning

confidence: 49%

Left Atrial Thrombus in Patients With Non-valvular Atrial Fibrillation: A Cross-Sectional Study in China

Shu

Zhao

Liu

et al. 2022

Front. Cardiovasc. Med.

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“…A national survey of middle-aged and older adults conducted between 2014 and 2016 indicated the weighted AF prevalence was 1.8% (11). A most recent epidemiological survey showed that the prevalence of AF in Chinese adults was 1.6% (Figure 1B), and it is estimated that currently approximately 20 million patients have AF in China, which is significantly higher than previously reported and the estimation (12). We anticipate that with an aging population, the growing trend in the causes of AF (such as ischemic heart disease), and the higher detection of AF with advanced technology and screening, the healthcare burden of AF will continue to increase in China.…”

Section: Burden Of Af In Chinamentioning

confidence: 77%

“…Two latter national investigations, performed in 2012 and 2014, respectively, showed that OAC use had increased to 31.7% and 43.7% in AF patients in China (20,21). The most recent data from the China AF Center (which involved 362 hospitals and is the (12) www.biosciencetrends.com BioScience Trends Advance Publication P3…”

Section: Unsatisfied Oac Use In Hospital-based Studiesmentioning

confidence: 99%

Contemporary oral anticoagulant therapy of patients with atrial fibrillation in China: Status, obstacles, and strategies for improvement

Shang

Zhang

Zhao

et al. 2022

BST

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Atrial fibrillation (AF) and subsequent stroke and death have become major public health problems in China. Oral anticoagulant (OAC) forms the backbone of prevention of AF-related stroke. However, the quality of OAC use in AF patients in China is not clear. The focus of this narrative review is to summarize the current status of OAC therapy in China and compare it with the studies conducted internationally. In general, most data of OAC use in China were reported around 10-50%, with an increasing proportion of high-risk patients receiving OACs, however, still much lower than those in other countries and regions. Moreover, the phenomenon of inappropriate OAC prescribing and poor long-term persistence and adherence with OAC therapy in AF patients in China have also been noted. The 1-year adherence and persistence of OACs are as low as 50%. Multiple factors from the physicians, patients, and OAC drugs contribute to these phenomena. The management of OACs in AF patients in China needs to be further improved by the joint efforts of healthcare administration (policy makers) and health systems including medical associations, hospitals, and physicians.

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“…China, as a developing country, is also trending toward a developed country in terms of AF prevalence. According to a national survey from 2017 to 2021, the total prevalence of AF in Chinese adults was 1.60% [6], which increased by 0.56% compared with the results of Wang et al in 2015-2017 [7]. AF is an important risk factor for Cerebral Ischemic Stroke (CIS).…”

Section: Introductionmentioning

confidence: 99%

Risk and economic cost of hospitalization due to atrial fibrillation caused by air pollution: a multi-city time series analysis

Lin

Jiang

et al. 2023

Environ Sci Eur

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Background Atrial fibrillation (AF) is the most common arrhythmia, resulting in serious cardiovascular diseases. Air pollution may cause heart rate disturbance, but there is no clear or consistent evidence that short-term exposure to air pollution leads to an increased risk of hospitalisation for symptomatic episodes of AF. This study aimed to assess the impact of short-term exposure to air pollution on inpatient numbers. Methods The inpatient records of AF cases in nine cities of the Sichuan Province, China and air pollution and meteorological data from 183 monitoring stations from 2017 to 2018 were collected. The impact of short-term exposure to air pollution on AF inpatients was evaluated using a time-stratified crossover case study design. The economic burden of AF attributable to air pollution was also estimated. Results A total of 5,958 patients with AF from 123 medical institutions were included in the analysis. Air pollutants had a significant impact on the number of patients with AF. The number increased by 2.5% (95% confidence interval [CI] = 1.006 to 1.044) and 1.8% (95% CI = 1.003–1.033) for every 10 µg/m3 increase in PM2.5, PM10, concentration, respectively. Moreover, the number increased by 12.7% (95% CI = 1.006 to 1.262) for every 10 µg/m3 increase of SO2 concentration. For every 0.1 μg/m3 increase in CO concentration, the number of inpatients with AF increased by 3.9% (95% CI = 1.010–1.070). People aged 65 years or older and women were more likely to be affected by air pollutants. The AF in 430 and 209 inpatients were attributable to PM2.5 and PM10, respectively. The total hospitalization expenses attributed to excessive exposure to PM2.5 and PM10 were 13.98 million CNY and 6.68 million CNY, respectively. Furthermore, the out-of-pocket expenses were 6.81 million CNY and 3.28 million CNY, respectively. Conclusions This study showed a strong correlation between air pollution and AF. Hence, there is a need to reduce air pollution to control health risks.

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Prevalence and risk of atrial fibrillation in China: A national cross-sectional epidemiological study

Cited by 45 publications

References 29 publications

Left Atrial Thrombus in Patients With Non-valvular Atrial Fibrillation: A Cross-Sectional Study in China

Left Atrial Thrombus in Patients With Non-valvular Atrial Fibrillation: A Cross-Sectional Study in China

Contemporary oral anticoagulant therapy of patients with atrial fibrillation in China: Status, obstacles, and strategies for improvement

Risk and economic cost of hospitalization due to atrial fibrillation caused by air pollution: a multi-city time series analysis

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