National Trends in Mortality Due to Ischemic Stroke Among Older Adults With Atrial Fibrillation in the USA, 1999–2020

IF 2.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Saeed Aftab Khan, Arfa Ahmed Assad, Hamza Ashraf, Hanzala Ahmed Farooqi, Sabahat Ul Ain Munir Abbasi, Hira Saleem, Reyan Khalid, Aala Saleh, Muhammad Hashim Akram
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引用次数: 0

Abstract

Background

Atrial fibrillation (AF) is a significant contributor to ischemic stroke risk and mortality, particularly in aging populations. This study examines mortality trends from ischemic stroke secondary to AF in the U.S. from 1999 to 2020, focusing on demographic and regional disparities.

Methods

Using data from the CDC WONDER database, this cross-sectional analysis included individuals aged ≥ 65 years with death certificates indicating ischemic stroke (ICD I63) and AF (ICD I48) as contributing causes. Age-adjusted mortality rates (AAMR) were calculated, and temporal trends were analyzed using join-point regression to estimate annual percentage changes (APC). Data were stratified by age, sex, race/ethnicity, urbanization, and geographic regions.

Results

From 1999 to 2020, ischemic stroke with AF caused 62,443 deaths (AAMR: 6.75/100,000; 95% CI: 6.70–6.80). Mortality rates increased significantly after 2010, peaking between 2014 and 2017 (APC: 31.3 for females, 28.1 for males). Older adults (≥ 85 years) exhibited the highest AAMR (43.2/100,000; 95% CI: 41.6–44.8). Nonmetropolitan areas consistently showed higher mortality compared to metropolitan regions. Demographic disparities were evident, with higher AAMRs in females, Whites, and the Western U.S., though Hispanics had the sharpest APC increase during 2014–2017.

Conclusion

Mortality rates from ischemic stroke with AF are rising in older adults, with significant demographic and regional disparities. The findings underscore the need for targeted public health strategies to mitigate AF-related stroke risks and improve healthcare equity.

Abstract Image

1999-2020年美国老年房颤患者缺血性卒中死亡率的全国趋势
背景房颤(AF)是缺血性卒中风险和死亡率的重要因素,特别是在老年人群中。本研究考察了1999年至2020年美国房颤继发缺血性卒中的死亡率趋势,重点关注人口统计学和地区差异。方法使用来自CDC WONDER数据库的数据,本横断面分析纳入年龄≥65岁且死亡证明表明缺血性卒中(ICD I63)和房颤(ICD I48)为主要原因的个体。计算年龄调整死亡率(AAMR),并使用联结点回归分析时间趋势,以估计年百分比变化(APC)。数据按年龄、性别、种族/民族、城市化和地理区域分层。结果1999 ~ 2020年,缺血性脑卒中合并房颤死亡62443例(AAMR: 6.75/10万;95% ci: 6.70-6.80)。死亡率在2010年之后显著上升,在2014年至2017年期间达到峰值(APC:女性31.3,男性28.1)。老年人(≥85岁)AAMR最高(43.2/10万;95% ci: 41.6-44.8)。非大都市地区的死亡率始终高于大都市地区。人口差异很明显,女性、白人和美国西部的aamr较高,尽管2014-2017年西班牙裔APC增幅最大。结论老年人缺血性脑卒中合并房颤的死亡率呈上升趋势,且存在明显的人口统计学和地区差异。研究结果强调了有针对性的公共卫生策略的必要性,以减轻心房颤动相关的卒中风险并改善医疗公平。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical Cardiology
Clinical Cardiology 医学-心血管系统
CiteScore
5.10
自引率
3.70%
发文量
189
审稿时长
4-8 weeks
期刊介绍: Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.
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