Abstract 19932: Secular Trends in Complications of Atrial Fibrillation 2004-2012: The Treat-AF Study
Background: Limited data indicates that complications of atrial fibrillation (AF) may be declining. We evaluated secular trends in AF outcomes over 8 years using complete data from the largest integrated health care system in the United States.
Methods: Using data from the TREAT-AF (The Retrospective Evaluation and Assessment of Therapies in AF) study from the U.S. Department of Veterans Affairs (VA) healthcare system, we identified patients with newly diagnosed, nonvalvular AF between from 2004 to 2012. Using VA and linked Medicare data, we determined the incidence rates for ischemic stroke, intracranial hemorrhage, extracranial hemorrhage, hospitalization for heart failure, and death from inpatient claims and medical record data using validated algorithms.
Results: In 184,161 patients with newly diagnosed AF (age 70.4±10.7; CHADS-VASC 2.6±1.7) the incidence rates, expressed as events per 1000 person-years, gradually decreased from 2004 to 2014 for ischemic stroke (12.1 to 8.0), intracranial hemorrhage (4.2 to 2.0), and death (86.3 to 63.7) (p < 0.05 for all, Table 1). Heart failure incidence rates slightly increased (44.3 to 50.6). Extracranial hemorrhage events were relatively stable until 2010, when the events gradually decreased from 19.6 to 16.8 events per 1000 person-years.
Conclusions: Among patients with newly-diagnosed AF from 2004-2012, the incidence rates of stroke (both hemorrhagic and ischemic), hemorrhage, and death have declined while heart failure admission rates have slightly increased. Causes and mediators require exploration but major sequelae following AF have dramatically changed.
Author Disclosures: D.W. Kaiser: Research Grant; Significant; Grant from the National Heart, Lung and Blood Institute (1T32Hl098049).. Consultant/Advisory Board; Modest; St. Jude Medical. A.C. Perino: None. J. Fan: None. S. Schmitt: None. M.P. Turakhia: Employment; Significant; Veterans Affairs. Research Grant; Significant; VA, AHA, Gilead, St Jude Medical, SentreHeart, Medtronic, iRhythm. Other Research Support; Significant; Jannsen, Boehringer-Ingelheim. Honoraria; Significant; Medtronic, St Jude, Biotronik. Ownership Interest; Significant; thryva, Zipline, Cyberheart, Metrica Health. Consultant/Advisory Board; Significant; St Jude Medical, Medtronic, Precision Health Economics.
- © 2015 by American Heart Association, Inc.