title: Decade-long trends in atrial fibrillation incidence and survival: a community study.
abstract: BACKGROUND
  Contemporary data on temporal trends in incidence and survival after atrial fibrillation are scarce.
  
  
  METHODS
  Residents of Olmsted County, Minn., with a first-ever atrial fibrillation or atrial flutter event between 2000 and 2010 were identified. Age- and sex-adjusted incidence rates were standardized to the 2010 US population, and the relative risk of atrial fibrillation in 2010 versus 2000 was calculated using Poisson regression. Standardized mortality ratios of observed versus expected survival were calculated, and time trends in survival were examined using Cox regression.
  
  
  RESULTS
  We identified 3344 patients with incident atrial fibrillation/atrial flutter events (52% were male, mean age 72.6 years, 95.7% were white). Incidence did not change over time (age- and sex-adjusted rate ratio, 1.01; 95% confidence interval [CI], 0.91-1.13 for 2010 vs 2000). Within the first 90 days, the risk of all-cause mortality was greatly elevated compared with individuals of a similar age and sex distribution in the general population (standardized mortality ratios 19.4 [95% CI, 17.3-21.7] and 4.2 [95% CI, 3.5-5.0] for the first 30 days and 31 to 90 days after diagnosis, respectively). Survival within the first 90 days did not improve over the study period (adjusted hazard ratio, 0.96; 95% CI, 0.71-1.32 for 2010 vs 2000); likewise, no difference in mortality between 2010 and 2000 was observed among 90-day survivors (hazard ratio, 1.05; 95% CI, 0.85-1.31).
  
  
  CONCLUSIONS
  In the community, atrial fibrillation incidence and survival have remained constant over the last decade. A dramatic and persistent excess risk of death was observed in the 90 days after atrial fibrillation diagnosis, underscoring the importance of early risk stratification.
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minn. Electronic address: chamberlain.alanna@mayo.edu.
authors.forename: Alanna M
authors.initials: AM
authors.lastname: Chamberlain
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn.
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Gersh
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Alonso
authors.affiliation: Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis.
authors.forename: Lin Y
authors.initials: LY
authors.lastname: Chen
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minn.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Berardi
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minn.
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Manemann
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minn.
authors.forename: Jill M
authors.initials: JM
authors.lastname: Killian
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minn.
authors.forename: Susan A
authors.initials: SA
authors.lastname: Weston
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minn; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn.
authors.forename: Véronique L
authors.initials: VL
authors.lastname: Roger
mesh_terms: D017677:Age Distribution; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology; D001282:Atrial Flutter / Q000175:diagnosis / Q000453:epidemiology; D016001:Confidence Intervals; D003625:Data Collection; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D009026:Mortality / Q000639:trends; D016016:Proportional Hazards Models; D012042:Registries; D018570:Risk Assessment; D017678:Sex Distribution
keywords: Atrial fibrillation; Epidemiology; Incidence; Survival