One in ten patients presenting to an emergency department with atrial fibrillation in developed countries will die within a year, most often from heart failure, a new study has found.
The situation is worse for those with less access to sophisticated medical care. The one-year mortality rates are 17% in South American and 20% in Africa.
Heart failure accounted for 30% of deaths, followed by other cardiovascular causes (about 25%). Stroke was the cause of 8% of deaths.
Stroke, whether fatal or non-fatal, occurred in the following year in 4% of patients. It was more common in patients for whom was a secondary diagnosis in the ED compared to those who were presenting primarily because of AF symptoms.
The findings were based on the RE-LY Atrial Fibrillation Registry, sponsored by Boehringer Ingelheim, which enrolled 15,400 patients between 2007 and 2011 in 47 countries.
Outcomes in North America, western Europe and Australia were used as the reference standard, for comparison with seven other regions ranging from South America to sub-Saharan Africa, China, India and Southeast Asia.
“Atrial fibrillation is a leading cause of morbidity and mortality worldwide,” the researchers wrote in The Lancet.
“However, most understanding of AF is based on findings from clinical trials and observational studies done in North America and western Europe, which exclude patients with secondary atrial fibrillation.