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期刊来源：BMJ

原文链接：https://doi.org/10.1136/bmj-2023-077209

摘要内容如下：

目标

研究房颤和房颤后并发症的终生风险如何随时间变化。

设计

丹麦，全国，基于人口的队列研究。

设置

2000年1月1日至2022年12月31日丹麦的人口。

参与者

350万人（51.7%的女性和48.3%的男性）在45岁或45岁以上时未发生房颤，随访至房颤发生、迁移、死亡或随访结束，以先发生者为准。所有362721例房颤患者（46.4%为女性，53.6%为男性），均未出现常见并发症，进一步随访直至发生心力衰竭、中风或心肌梗死。

主要结果指标

房颤的终生风险和房颤后并发症的终生风险超过两个预先指定的时期（2000-10 V 2011-22）。

结果

房颤的终生风险从2000-10年的24.2%增加到2011-22年的30.9%（差异6.7%（95%置信区间6.5%至6.8%））。房颤后，最常见的并发症是心力衰竭，其终生风险在2000-10年为42.9%，在2011-22年为42.1%（-0.8%（-3.8%至2.2%））。房颤患者在没有心力衰竭的情况下损失了14.4年。房颤后卒中和心肌梗死的终生风险在两个时期之间略有下降，卒中风险从22.4%降至19.9%（-2.5%（-4.2%至-0.7%）），心肌梗死风险从13.7%降至9.8%（-3.9%（-5.3%至-2.4%））。据报告，没有证据表明男女之间的差异有所减少。

结论

在二十年的随访中，房颤的终生风险增加。在房颤患者中，大约五分之二的人在房颤诊断后的剩余生命中发生了心力衰竭，五分之一的人发生了中风，随着时间的推移没有改善或仅有很小的改善。房颤患者需要中风风险和心力衰竭预防策略。

英文原文如下：

Abstracts

OBJECTIVES  To examine how the lifetime risks of atrial fibrillation and of complications after atrial fibrillation changed over time.

DESIGN  Danish, nationwide, population based cohort study.

SETTING  Population of Denmark from 1 January 2000 to 31 December 2022.

PARTICIPANTS  3.5 million individuals (51.7% women and 48.3% men) who did not have atrial fibrillation at 45 years of age or older were followed up until incident atrial fibrillation, migration, death, or end of follow-up, whichever came first. All 362 721 individuals with incident atrial fibrillation (46.4% women and 53.6% men), but with no prevalent complication, were further followed up until incident heart failure, stroke, or myocardial infarction.

MAIN OUTCOME MEASURES  Lifetime risk of atrial fibrillation and lifetime risks of complications after atrial fibrillation over two prespecified periods (2000-10 v 2011-22).

RESULTS  The lifetime risk of atrial fibrillation increased from 24.2% in 2000-10 to 30.9% in 2011-22 (difference 6.7% (95% confidence interval 6.5% to 6.8%)). After atrial fibrillation, the most frequent complication was heart failure with a lifetime risk of 42.9% in 2000-10 and 42.1% in 2011-22 (-0.8% (-3.8% to 2.2%)). Individuals with atrial fibrillation lost 14.4 years with no heart failure. The lifetime risks of stroke and of myocardial infarction after atrial fibrillation decreased slightly between the two periods, from 22.4% to 19.9% for stroke (-2.5% (-4.2% to -0.7%)) and from 13.7% to 9.8% for myocardial infarction (-3.9% (-5.3% to -2.4%). No evidence was reported of a differential decrease between men and women.

CONCLUSION  Lifetime risk of atrial fibrillation increased over two decades of follow-up. In individuals with atrial fibrillation, about two in five developed heart failure and one in five had a stroke over their remaining lifetime after atrial fibrillation diagnosis, with no or only small improvement over time. Stroke risks and heart failure prevention strategies are needed for people with atrial fibrillation.

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