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Sex differences in early-onset atrial fibrillation in Norwegian primary care: a retrospective national database analysis

BackgroundIndividual variation in the need for healthcare constitutes knowledge gaps for young atrial fibrillation (AF) patients. We aimed to estimate the prevalence and primary care burden of early-onset AF in Norway, emphasising sex differences, in a nationwide healthcare database.MethodsWe used d...

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Published in:Open heart 2024-08, Vol.11 (2), p.e002695
Main Authors: Kalstø, Silje Madeleine, Nygård, Ståle, Ariansen, Inger, Tveit, Arnljot, Christophersen, Ingrid Elisabeth
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Nygård, Ståle
Ariansen, Inger
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Christophersen, Ingrid Elisabeth
description BackgroundIndividual variation in the need for healthcare constitutes knowledge gaps for young atrial fibrillation (AF) patients. We aimed to estimate the prevalence and primary care burden of early-onset AF in Norway, emphasising sex differences, in a nationwide healthcare database.MethodsWe used data from the Norwegian Control and Payment of Health Reimbursement database to identify all Norwegian residents ≥18 years of age registered with a primary care physician (PCP) in 2019, with onset of AF at ≤50 years of age (early-onset AF) in the period 2006–2019. From the accumulated number of early-onset AF cases among current residents, we calculated the prevalence in 2019. The group-level primary care burden was calculated as the total number of annual AF consultations divided by the annual number of AF patients (2014–2018), and individual burden as the mean number of consultations per AF patient per year within the study period. We analysed the distribution of AF consultations between PCP and primary care emergency room (ER) services in total and by sex.ResultsWe identified 10 925 Norwegian residents with early-onset AF in 2019 (26.3% women, mean age 48.4 years). The prevalence of early-onset AF was 0.34% (women: 0.19%, men: 0.50%). The early-onset AF population had on average one annual primary care consultation for AF. The individual burden of annual AF consultations varied widely;
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We aimed to estimate the prevalence and primary care burden of early-onset AF in Norway, emphasising sex differences, in a nationwide healthcare database.MethodsWe used data from the Norwegian Control and Payment of Health Reimbursement database to identify all Norwegian residents ≥18 years of age registered with a primary care physician (PCP) in 2019, with onset of AF at ≤50 years of age (early-onset AF) in the period 2006–2019. From the accumulated number of early-onset AF cases among current residents, we calculated the prevalence in 2019. The group-level primary care burden was calculated as the total number of annual AF consultations divided by the annual number of AF patients (2014–2018), and individual burden as the mean number of consultations per AF patient per year within the study period. We analysed the distribution of AF consultations between PCP and primary care emergency room (ER) services in total and by sex.ResultsWe identified 10 925 Norwegian residents with early-onset AF in 2019 (26.3% women, mean age 48.4 years). The prevalence of early-onset AF was 0.34% (women: 0.19%, men: 0.50%). The early-onset AF population had on average one annual primary care consultation for AF. The individual burden of annual AF consultations varied widely; &lt;1: 66% of women and 54% of men, (1–5]: 25% of women and 36% of men, (5–10]: 6% of women and 8% of men, ≥10: 2% of women and 2% of men. A higher proportion of men (71%) than women (38%) attended both PCP and ER services due to AF.ConclusionsThe study confirmed a low prevalence of early-onset AF, with substantial sex differences and individual variation in primary healthcare needs. Our results signal a need for a higher resolution with regard to age groups in future research on burden and sex differences in early-onset AF.</description><identifier>ISSN: 2053-3624</identifier><identifier>ISSN: 2398-595X</identifier><identifier>EISSN: 2053-3624</identifier><identifier>DOI: 10.1136/openhrt-2024-002695</identifier><identifier>PMID: 39164045</identifier><language>eng</language><publisher>England: British Cardiovascular Society</publisher><subject>Adolescent ; Adult ; Age groups ; Age of Onset ; Atrial Fibrillation ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - epidemiology ; Cardiac arrhythmia ; Codes ; Databases, Factual ; Datasets ; Delivery of Health Care ; Emergency medical care ; Epidemiology ; Female ; Gender differences ; Global Burden of Disease ; Health care delivery, economics and global health care ; Hospitals ; Humans ; Male ; Middle Aged ; Norway - epidemiology ; Patients ; Prevalence ; PRIMARY CARE ; Primary Health Care - statistics &amp; numerical data ; Reimbursement ; Retrospective Studies ; Risk Factors ; Sex Distribution ; Sex Factors ; Womens health ; Working hours ; Young Adult ; Young adults</subject><ispartof>Open heart, 2024-08, Vol.11 (2), p.e002695</ispartof><rights>Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2024 Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . 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We aimed to estimate the prevalence and primary care burden of early-onset AF in Norway, emphasising sex differences, in a nationwide healthcare database.MethodsWe used data from the Norwegian Control and Payment of Health Reimbursement database to identify all Norwegian residents ≥18 years of age registered with a primary care physician (PCP) in 2019, with onset of AF at ≤50 years of age (early-onset AF) in the period 2006–2019. From the accumulated number of early-onset AF cases among current residents, we calculated the prevalence in 2019. The group-level primary care burden was calculated as the total number of annual AF consultations divided by the annual number of AF patients (2014–2018), and individual burden as the mean number of consultations per AF patient per year within the study period. We analysed the distribution of AF consultations between PCP and primary care emergency room (ER) services in total and by sex.ResultsWe identified 10 925 Norwegian residents with early-onset AF in 2019 (26.3% women, mean age 48.4 years). The prevalence of early-onset AF was 0.34% (women: 0.19%, men: 0.50%). The early-onset AF population had on average one annual primary care consultation for AF. The individual burden of annual AF consultations varied widely; &lt;1: 66% of women and 54% of men, (1–5]: 25% of women and 36% of men, (5–10]: 6% of women and 8% of men, ≥10: 2% of women and 2% of men. A higher proportion of men (71%) than women (38%) attended both PCP and ER services due to AF.ConclusionsThe study confirmed a low prevalence of early-onset AF, with substantial sex differences and individual variation in primary healthcare needs. 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We aimed to estimate the prevalence and primary care burden of early-onset AF in Norway, emphasising sex differences, in a nationwide healthcare database.MethodsWe used data from the Norwegian Control and Payment of Health Reimbursement database to identify all Norwegian residents ≥18 years of age registered with a primary care physician (PCP) in 2019, with onset of AF at ≤50 years of age (early-onset AF) in the period 2006–2019. From the accumulated number of early-onset AF cases among current residents, we calculated the prevalence in 2019. The group-level primary care burden was calculated as the total number of annual AF consultations divided by the annual number of AF patients (2014–2018), and individual burden as the mean number of consultations per AF patient per year within the study period. We analysed the distribution of AF consultations between PCP and primary care emergency room (ER) services in total and by sex.ResultsWe identified 10 925 Norwegian residents with early-onset AF in 2019 (26.3% women, mean age 48.4 years). The prevalence of early-onset AF was 0.34% (women: 0.19%, men: 0.50%). The early-onset AF population had on average one annual primary care consultation for AF. The individual burden of annual AF consultations varied widely; &lt;1: 66% of women and 54% of men, (1–5]: 25% of women and 36% of men, (5–10]: 6% of women and 8% of men, ≥10: 2% of women and 2% of men. A higher proportion of men (71%) than women (38%) attended both PCP and ER services due to AF.ConclusionsThe study confirmed a low prevalence of early-onset AF, with substantial sex differences and individual variation in primary healthcare needs. Our results signal a need for a higher resolution with regard to age groups in future research on burden and sex differences in early-onset AF.</abstract><cop>England</cop><pub>British Cardiovascular Society</pub><pmid>39164045</pmid><doi>10.1136/openhrt-2024-002695</doi><orcidid>https://orcid.org/0000-0001-8529-4826</orcidid><orcidid>https://orcid.org/0000-0002-6141-4712</orcidid><orcidid>https://orcid.org/0009-0008-1673-0071</orcidid><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Adult
Age groups
Age of Onset
Atrial Fibrillation
Atrial Fibrillation - diagnosis
Atrial Fibrillation - epidemiology
Cardiac arrhythmia
Codes
Databases, Factual
Datasets
Delivery of Health Care
Emergency medical care
Epidemiology
Female
Gender differences
Global Burden of Disease
Health care delivery, economics and global health care
Hospitals
Humans
Male
Middle Aged
Norway - epidemiology
Patients
Prevalence
PRIMARY CARE
Primary Health Care - statistics & numerical data
Reimbursement
Retrospective Studies
Risk Factors
Sex Distribution
Sex Factors
Womens health
Working hours
Young Adult
Young adults
title Sex differences in early-onset atrial fibrillation in Norwegian primary care: a retrospective national database analysis
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