Atrial fibrillation in the Tromsø Study 1986-2017: incidence trends, contribution of risk factors and prognostic outcomes

Project period: 1 April 2018 – 31 March 2021

Project leader: Ekaterina Sharashova, MD, PhD, posdoctoral researcher at the Department of Community Medicine, UiT

Collaborators:
Maja-Lisa Løchen, MD, PhD, professor at Department of Community Medicine, UiT The Arctic University of Norway, and a senior consultant cardiology at UNN Tromsø
Henrik Schirmer, MD, PhD, professor at UiO and UiT The Arctic University of Norway
Tom Wilsgaard, PhD, professor at Department of Community Medicine, UiT The Arctic University of Norway, and a researcher at Centre for Quality and Development, UNN Tromsø
Inger Njølstad, MD, PhD, professor at Department of Community Medicine, UiT The Arctic University of Norway
Ellisiv B Mathiesen, MD, PhD, professor at Department of Clinical Medicine, UiT The Arctic University of Norway, and a neurologist at UNN Tromsø
Annika Rosengren, MD, PhD, professor and chief physician, Department of Molecular and Clinical Medicine, The Sahlgrenska Academy, University of Gothenburg, Sweden
Audhild Nyrnes, MD, PhD, a senior consultant at Section of Geriatrics, UNN Tromsø
Jocasta Ball, PhD, a senior research officer and early career fellow at Baker Heart and Diabetes Institute in Melbourne, Australia
Eva Gerdts, MD, PhD, professor at Faculty of Medicine, UiB
Bjarne Koster Jacobsen, PhD, professor at Department of Community Medicine, UiT The Arctic University of Norway
Simon Kildal, MD, an internship doctor at UNN Narvik
Sweta Tiwari, MPH, PhD student at Department of Community Medicine, UiT The Arctic University of Norway

Project is about:

The project aims to study the natural history of atrial fibrillation. The findings may identify strategies for risk lowering of atrial fibrillation development and outcomes and change clinical practice.

Aims:

• To explore incidence trends in atrial fibrillation and outcomes, and the impact of risk factor changes in the Tromsø Study 1986-2017

• To study the role of psychological factors and quality of life in the development of atrial fibrillation and outcomes

• To explore associations between blood pressure, blood pressure changes and risk of outcomes in atrial fibrillation patients

• To study change in stroke risk in atrial fibrillation patients related to the introduction of direct oral anticoagulants as an alternative to warfarin in 2011

• To investigate bidirectional associations between atrial fibrillation and heart failure

Summary:

Atrial fibrillation is an increasingly common arrhythmia in our ageing population with major economic and health consequences such as stroke and premature death. Although atrial fibrillation prevalence and incidence are increasing, many aspects of this new epidemic of cardiovascular disease concerning both atrial fibrillation occurrence, progression and management are not fully elucidated. This project aims to cover some of the important knowledge gaps and to study the natural history of atrial fibrillation in a Norwegian population over time with a focus on sex differences. The project is based on the population-based Tromsø Study 1986-2017 merged with the Norwegian Patient Registry and the Norwegian Prescription Database. Main advantages are the longitudinal design, repeated risk factor measurements, validated follow-up information, and the large sample size. We will explore secular trends in the incidence of atrial fibrillation, its clinical complications and hospitalisation rates over recent decades, and will estimate the contribution of risk factors with a special focus on such modifiable factors as hypertension and psychological aspects. The two comorbid conditions atrial fibrillation and heart failure frequently coexist and complicate the course and treatment of each other. The direction of cause and effect with the conditions is yet to be fully elucidated. Important is also to study the risk of stroke for atrial fibrillation patients related to the introduction of direct oral anticoagulants as an alternative to warfarin in Norway in 2011. id4215

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