Trends in stroke-related mortality in atrial fibrillation patients in the United States: Insights from the CDC WONDER database
2024

Trends in Stroke-Related Mortality in Atrial Fibrillation Patients in the U.S.

Sample size: 331106 publication 10 minutes Evidence: high

Author Information

Author(s): Naveed Muhammad Abdullah, Neppala Sivaram, Chigurupati Himaja Dutt, Rehan Muhammad Omer, Ali Ahila, Naveed Hamza, Azeem Bazil, Iqbal Rabia, Mubeen Manahil, Ahmed Mashood, Fath Ayman R., Paul Timir, Munir Bilal

Primary Institution: Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan

Hypothesis

What are the demographic trends and disparities in mortality rates due to stroke in atrial fibrillation patients aged 25 years and older?

Conclusion

The study reveals significant demographic and geographic disparities in mortality rates attributed to stroke associated with atrial fibrillation.

Supporting Evidence

  • The overall Age-Adjusted Mortality Rate (AAMR) associated with strokes from atrial fibrillation (AF) declined from 7.4 in 1999 to 6.4 in 2020.
  • A higher AAMR was observed in adult women compared to men, with women demonstrating a decreasing trend from 1999 to 2020.
  • From 1999 to 2020, both Asian and white populations experienced a decrease in mortality rates, while no mortality rates of other races showed no variation.
  • Western states and Nonmetropolitan areas demonstrated notably higher mortality rates than other states and areas.

Takeaway

This study looked at how many people with atrial fibrillation died from strokes over 20 years and found that fewer people are dying now, but some groups are still affected more than others.

Methodology

A retrospective analysis of death data from the CDC WONDER database from 1999 to 2020, calculating age-adjusted mortality rates and trends.

Potential Biases

Potential for misclassification bias due to reliance on death certificates.

Limitations

The study relies on death certificates, which may introduce misclassification bias, and lacks detailed clinical data.

Participant Demographics

Adults aged 25 years and older diagnosed with atrial fibrillation.

Statistical Information

P-Value

0.004

Confidence Interval

95% CI: −1.55 to −0.53

Statistical Significance

p<0.000001

Digital Object Identifier (DOI)

10.1016/j.ahjo.2024.100491

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