Background and Aims Patients with atrial fibrillation (AF) are at increased risks of cardiovascular diseases and mortality, but risks according to age at diagnosis have not been reported. This study investigated age-specific risks of outcomes among patients with AF and the background population. Methods This nationwide population-based cohort study included patients with AF and controls without outcomes by the application of exposure density matching on the basis of sex, year of birth, and index date. The absolute risks and hazard rates were stratified by age groups and assessed using competing risk survival analyses and Cox regression models, respectively. The expected differences in residual life years among participants were estimated. Results The study included 216 579 AF patients from year 2000 to 2020 and 866 316 controls. The mean follow-up time was 7.9 years. Comparing AF patients with matched controls, the hazard ratios among individuals ≤50 years was 8.90 [95% confidence interval (CI), 7.17–11.0] for cardiomyopathy, 8.64 (95% CI, 7.74–9.64) for heart failure, 2.18 (95% CI, 1.89–2.52) for ischaemic stroke, and 2.74 (95% CI, 2.53–2.96) for mortality. The expected average loss of life years among individuals ≤50 years was 9.2 years (95% CI, 9.0–9.3) years. The estimates decreased with older age. Conclusions The findings show that earlier diagnosis of AF is associated with a higher hazard ratio of subsequent myocardial disease and shorter life expectancy. Further studies are needed to determine causality and whether AF could be used as a risk marker among particularly younger patients.

中文翻译：

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心房颤动：诊断年龄、心血管事件发生率和死亡率

背景和目的 房颤 (AF) 患者患心血管疾病和死亡的风险增加，但尚未报告根据诊断时年龄的风险。本研究调查了 AF 患者和背景人群的特定年龄结局风险。方法 这项全国性的基于人群的队列研究纳入了房颤患者和对照，通过应用基于性别、出生年份和索引日期的暴露密度匹配而没有结果。绝对风险和危险率按年龄组分层，并分别使用竞争风险生存分析和 Cox 回归模型进行评估。估计了参与者的剩余寿命年的预期差异。结果 该研究纳入了 2000 年至 2020 年期间的 216 579 名 AF 患者和 866 316 名对照者。平均随访时间为 7.9 年。将 AF 患者与匹配对照进行比较，≤50 岁个体的心肌病风险比为 8.90 [95% CI，7.17–11.0]，心力衰竭为 8.64（95% CI，7.74–9.64），心力衰竭为 2.18（95缺血性卒中的 % CI，1.89–2.52），死亡率的 2.74（95% CI，2.53–2.96）。 ≤50岁个体的预期平均寿命损失为9.2年（95% CI，9.0-9.3）年。随着年龄的增长，这一估计值会下降。结论 研究结果表明，房颤的早期诊断与后续心肌疾病的较高风险比和较短的预期寿命相关。需要进一步的研究来确定因果关系以及 AF 是否可以作为特别年轻患者的风险标记。