Objective To examine long-time trend in incidence and mortality of atrial fibrillation (AF) and influences of age, period and birth cohort on the incidence and mortality among Chinese population and to provide evidences for developing AF prevention and control strategies.
Methods The data on AF incidence and mortality from 1993 through 2017 in China were collected from the results of the Global Burden of Diseases Study 2017 (GBD 2017). An R-based web tool from the United States National Cancer Institute for age-period-cohort (APC) analysis was used in this study. The data were arranged to conduct APC analysis for assessing effects of age, period and cohort on AF incidence and mortality.
Results Increasing trend in the crude and age standardized AF incidence and mortality were observed during the 25-year period in China. The increments during the period of 1993 – 2017 for the crude rate (1/100 000) and age-standardized rate (1/100 000) of AF incidence and mortality for male and female populations were as following: (1) crude AF incidence: 20.61 vs. 42.30 and 24.90 vs. 42.30; (2) age-standardized AF incidence: 30.35 vs. 32.67 and 31.95 vs. 34.18; (3) crude AF mortality: 0.79 vs. 2.32 and 1.89 vs. 4.64; and (4) age-standardized AF mortality: 2.46 vs. 2.78 and 3.78 vs. 3.86. The results of APC analysis demonstrated that the net drift of AF incidence and mortality for male and female populations were all above 0 (AF incidence: 16.595% and 16.527%, AF mortality: 28.570% and 29.026%). Both the incidence and mortality risk of AF increased sharply with the increment of age in a 'J' shaped pattern and the highest AF incidence and mortality risk were observed in populations aged 80 – 89 years. Compared to those during the period of 2003 – 2007, the risk of AF incidence was higher for the periods of 1993 – 2002 and 2008 – 2012 but lower for the period of 2013 – 2017. The risk of AF mortality increased yearly during the 25-year period, and the increase was more dramatic for the years of 2008 – 2017. The risk of AF incidence and mortality for people born between 1976 and 1985 increase with their year of birth in a 'J' shaped exponential pattern.
Conclusion The incidence and mortality of atrial fibrillation increased persistently during 1993 – 2017 for Chinese population due to impacts of age, period and birth cohort effect.
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