Global burden, trends, and inequalities of atrial fibrillation and flutter among young adults from 1990 to 2019: a population-based study

Abstract

Purpose: Atrial fibrillation and flutter (AF/AFL) represents a common, persistent arrhythmia. However, its impact on adults aged 25–49 years remains under-researched. This study aims to thoroughly evaluate the global burden and trends of AF/AFL over the past three decades (1990–2019) in the aforementioned age group, while also investigating health disparities linked to socioeconomic progress. Methods: The incidence and disability-adjusted life years (DALYs) rates of AF/AFL in young adults worldwide were analyzed, utilizing data from the Global Burden of Disease Study 2019 (GBD 2019). Trends over the study period were assessed using joinpoint regression analysis. The study also explored variations in the AF/AFL burden related to the socio-demographic index (SDI) across different countries through health inequality analysis. Results: According to GBD 2019 data, the global incidence, deaths, and DALYs of AF/AFL patients were 2,210,732 (95% UI, 1,444,894–3,250,516), 408,336 (248236–604689), 2,017 (1,798–2,306), and 275,258 (190,070–382,740), respectively. These figures represent 3.70%, 8.65%, 0.64%, and 3.28% of the total world population. Over the last three decades, the prevalence [AAPC = 0.42%, 95% CI (0.37%–0.47%)], incidence [AAPC = 0.31%, 95% CI (0.27%-0.35%)], years lived with disability (YLDs) [AAPC = 0.43%, 95% CI (0.38%–0.48%)], and DALY [AAPC = 0.48%, 95% CI (0.42%-0.53%)] rates of AF/AFL in young adults have exhibited increasing trends. Additionally, young adults in countries with higher SDI had disproportionate increases in AF/AFL burdens. Shifts in the inequality slope index for DALYs and the concentration index were detected in young adults with AF/AFL from 7.02 [95% CI (5.71–8.34)] in 1990 to 8.10 [95% CI (6.81–9.40)] in 2019 and from 13.25 [95% CI (11.54–14.97)] in 1990 to 12.33 [95% CI (10.49–14.18)] in 2019. In addition, shifts in the inequality slope indices for the prevalence and concentration indices were detected in young adults with AF/AFL from 68.49 [95% CI (55.44–81.54)] in 1990 to 83.54 [95% CI (70.45–96.62)] in 2019 and from 15.87 [95% CI (13.49–18.26)] in 1990 to 18.32 [95% CI (16.09–20.55)] in 2019. Conclusions: In addition to the increase in the incidence, YLD, and DALY rates of AF/AFL in young adults worldwide in the last three decades, the degree of SDI-related inequality in different countries has shown an increasing trend. Therefore, wise resource allocation and effective strategy implementation should be taken into consideration by immune makers from different countries; thus, improving the global AF/AFL burden in young adults and addressing related health inequalities.