Atrial fibrillation and flutter as global drivers of heart failure: Burden and longitudinal trends over three decades

IF 3.7 2区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

ESC Heart Failure Pub Date : 2025-06-13 DOI:10.1002/ehf2.15344

Yabin Liu, Jingsi Duan, Yue Wang, Nicola Luigi Bragazzi, Mengying Huang, Huimin Chen, Haijiang Dai, Cheng Ni

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引用次数: 0

Abstract

Aims

The study aims to comprehensively evaluate the global burden of heart failure attributable to atrial fibrillation (AF) and atrial flutter (AFL) from 1990 to 2021.

Methods

Using data from the Global Burden of Disease Study 2021, we estimated the prevalence and years lived with disability (YLDs) of heart failure attributable to AF/AFL across 204 countries and territories. Estimates were stratified by age, sex and socio-demographic index (SDI). Age-standardized rates per 100 000 population were calculated, and percentage changes between 1990 and 2021 were analysed to assess temporal trends.

Results

In 2021, AF/AFL were responsible for an estimated 714 137.5 [95% uncertainty interval (UI) 520 543.5 to 940 900.6] heart failure cases and 63 942.8 (95% UI 39 057.9 to 96 196.5) YLDs globally. The age-standardized prevalence and YLD rates were 8.85 (95% UI 6.38 to 11.63) and 0.79 (95% UI 0.49 to 1.19) per 100 000 population, respectively. Between 1990 and 2021, global absolute numbers of heart failure cases and YLDs attributable to AF/AFL increased by 339.3% (95% UI 292.7 to 387.0) and 337.5% (95% UI 290.1 to 387.0), respectively. Age-standardized prevalence and YLD rates increased by 65.2% (95% UI 47.7 to 83.8) and 65.4% (95% UI 46.6 to 83.5), respectively. The burden progressively increased with age, peaking among individuals aged ≥95 years. Females experienced a higher burden than males from age 55 years onward, with the greatest disparity observed in the 85–89 years age group. High SDI regions, such as Australasia and Western Europe, exhibited the highest prevalence and YLD rates.

Conclusions

The global burden of heart failure attributable to AF/AFL increased substantially from 1990 to 2021, disproportionately affecting older adults, females aged 55 years and above and populations in high SDI regions. These findings highlight the urgent need for targeted interventions and resource allocation to address the growing challenges, particularly for vulnerable groups.

Abstract Image

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房颤和扑动作为心力衰竭的全球驱动因素：三十年来的负担和纵向趋势。

目的：该研究旨在全面评估1990年至2021年心房颤动（AF）和心房扑动（AFL）引起的心力衰竭的全球负担。方法：使用来自2021年全球疾病负担研究的数据，我们估计了204个国家和地区AF/AFL引起的心力衰竭的患病率和残疾生活年数（YLDs）。估计按年龄、性别和社会人口指数（SDI）分层。计算了每10万人的年龄标准化率，并分析了1990年至2021年之间的百分比变化，以评估时间趋势。结果：2021年，AF/AFL导致全球约714 137.5例[95%不确定区间（UI） 520 543.5至940 900.6]心力衰竭病例和63 942.8例（95% UI 39 057.9至96 196.5）YLDs。年龄标准化患病率和YLD分别为8.85 （95% UI为6.38 ~ 11.63）和0.79 (95% UI为0.49 ~ 1.19)/ 10万人口。1990年至2021年间，全球AF/AFL导致的心力衰竭病例和YLDs绝对数量分别增加了339.3% （95% UI 292.7至387.0）和337.5% （95% UI 290.1至387.0）。年龄标准化患病率和YLD分别上升65.2% （95% UI为47.7 ~ 83.8）和65.4% （95% UI为46.6 ~ 83.5）。随着年龄的增长，负担逐渐增加，在≥95岁时达到高峰。从55岁开始，女性的负担高于男性，在85-89岁年龄组中观察到的差异最大。高SDI地区，如大洋洲和西欧，表现出最高的患病率和YLD率。结论：从1990年到2021年，AF/AFL导致的全球心力衰竭负担大幅增加，不成比例地影响老年人、55岁及以上的女性和高SDI地区的人群。这些发现突出表明，迫切需要有针对性的干预措施和资源分配，以应对日益严峻的挑战，特别是针对弱势群体的挑战。

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

ESC Heart Failure Medicine-Cardiology and Cardiovascular Medicine

CiteScore

7.00

自引率

7.90%

发文量

461

审稿时长

12 weeks

期刊介绍： ESC Heart Failure is the open access journal of the Heart Failure Association of the European Society of Cardiology dedicated to the advancement of knowledge in the field of heart failure. The journal aims to improve the understanding, prevention, investigation and treatment of heart failure. Molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, as well as the clinical, social and population sciences all form part of the discipline that is heart failure. Accordingly, submission of manuscripts on basic, translational, clinical and population sciences is invited. Original contributions on nursing, care of the elderly, primary care, health economics and other specialist fields related to heart failure are also welcome, as are case reports that highlight interesting aspects of heart failure care and treatment.