Table_2_Burden of atrial fibrillation and its attributable risk factors from 1990 to 2019: An analysis of the Global Burden of Disease study 2019.docx

BackgroundUnderstanding the pattern and trend of the atrial fibrillation (AF) burden are essential for developing effective preventive strategies. The purpose of this study was to estimate AF burdens and risk factors in 204 countries and territories between 1990 and 2019.
Materials and methodsData were extracted from the Global Burden of Disease 2019, including incidence, death, disability-adjusted life-years (DALYs), and the attributable risk factors. In order to quantify changes in the age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), and age-standardized DALY rate between 1990 and 2019, the estimated annual percentage change (EAPC) was used. Also, AF burden was assessed in relation to the Socio-demographic Index (SDI).
ResultsGlobally, there were 4,720,324 incident cases, 117,038 deaths and 8,393,635 DALYs in 2019. There were no significant changes in ASIR, ASDR, or age-standardized DALY rates from 1990 to 2019. Although the burden and trend of AF varied in different regions and countries, the ASIR, ASDR and age-standardized DALY rate were positively correlated with SDI. Furthermore, the burden of AF was higher in males and elderly. The age-standardized DALY rate worldwide was primarily attributable to high systolic blood pressure, followed by high body-mass index, alcohol use, smoking, diet high in sodium and lead exposure.
ConclusionAF remained a major public health challenge worldwide, with substantial variation at regional and national levels. There is an urgent need to increase public awareness about AF risk factors and to bring about cost-effective interventions for AF in order to reduce its future burden.

背景：阐明心房颤动（atrial fibrillation, AF）负担的模式与趋势，对于制定高效的预防策略至关重要。本研究旨在估算1990至2019年间全球204个国家和地区的AF负担及其危险因素。
材料与方法：本研究数据来源于《2019年全球疾病负担研究》，涵盖发病率、死亡数、伤残调整寿命年（disability-adjusted life-years, DALYs）及可归因危险因素。为量化1990至2019年间年龄标准化发病率（age-standardized incidence rate, ASIR）、年龄标准化死亡率（age-standardized death rate, ASDR）与年龄标准化DALY率的变化趋势，本研究采用估计年度百分比变化（estimated annual percentage change, EAPC）进行分析。此外，本研究还结合社会人口指数（Socio-demographic Index, SDI）对AF负担进行评估。
结果：2019年全球新增AF病例4720324例，死亡117038例，伤残调整寿命年总计8393635人年。1990至2019年间，全球ASIR、ASDR及年龄标准化DALY率均无显著变化。尽管不同国家与地区的AF负担及趋势存在差异，但ASIR、ASDR与年龄标准化DALY率均与SDI呈正相关。此外，男性与老年群体的AF负担更高。全球年龄标准化DALY率主要归因于高收缩压，其次为高体质量指数、酒精摄入、吸烟、高钠饮食及铅暴露。
结论：心房颤动仍是全球范围内亟待应对的重大公共卫生挑战，且不同国家与地区间的差异显著。当前亟需提升公众对AF危险因素的认知，并针对AF制定具有成本效益的干预措施，以降低其未来疾病负担。