Atrial fibrillation (AF) is the most frequent heart-rhythm problem and is associated with increased risk of death. We aim to clarify the natural history, causes of hospitalization and death (cardiac or non-cardiac) in patients diagnosed with AF, and ascertain which (if any) are more frequent in patients with this condition. We will be using nationwide patient information collected by GPs, and hospitals to conduct our research. These patients will be compared with similar patients without the disease. Also, as AF can behave in very different ways, we want to identify the different groups of patients presenting with this disease in the UK, and the characteristics (e.g. being overweight, alcohol. etc.) which make them more prone to develop specific complications (i.e. which patients with AF develop heart failure, stroke, dementia, cancer, or others). This may allow us to understand which individuals with AF are at higher risk of doing poorly. This is of importance, as we believe that not all AF individuals are equal, and they shouldn't all be treated equally. Some individuals may benefit from treatment specifically aimed at their underlying diseases, which may lead to an improvement in AF while the disease is still in its early form.
The presentation of atrial fibrillation (AF) varies widely, and its natural history, including causes of death, and development of conditions like cancer, dementia and heart failure following its diagnosis remains to be elucidated. A better understanding of this arrhythmia's natural history and behavior in particular clusters of patients may allow us to develop individualized preventive and therapeutic measures to improve these patients' outcome and quality of life.
Using linked electronic health records from CPRD, HES, ONS, we aim to
Assess the natural history of patients with AF in the UK:
(i) we will describe the event rate and specific causes of mortality and reasons for hospitalizations in patients with a new diagnosis of AF.
(ii) Using time-varying exposure and time-dependent effect models (flexible hazard models), we will investigate if patients with AF have a higher rate of complications (fatal events and non-fatal hospitalizations) than people without AF in the UK.
Rui Providencia - Chief Investigator - St Bartholomew's Hospital
Rui Providencia - Corresponding Applicant - St Bartholomew's Hospital
Adam D'Souza - Collaborator - University of Calgary
Alexander Wright - Collaborator - University College London ( UCL )
Anthony Hunter - Collaborator - University College London ( UCL )
Arturo Gonzalez-Izquierdo - Collaborator - University College London ( UCL )
Bernard Rachet - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Caroline Dale - Collaborator - University College London ( UCL )
David Prieto-Merino - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Dionisio Acosta Mena - Collaborator - University College London ( UCL )
Fenghua You - Collaborator - University College London ( UCL )
Frances Bennett - Collaborator - University College London ( UCL )
Hannah Evans - Collaborator - University College London ( UCL )
Juan M Garcia-Gomez - Collaborator - Technical University of Valencia
Juan Pablo Casas Romero - Collaborator - University College London ( UCL )
Julian Halcox - Collaborator - Swansea University
Julie Taylor - Collaborator - Farr Institute of Health Informatics Research
Kishore Kukendra-Rajah - Collaborator - University College London ( UCL )
Louis Prosser - Collaborator - University College London ( UCL )
Maria De Iorio - Collaborator - University College London ( UCL )
Michail Katsoulis - Collaborator - Farr Institute of Health Informatics Research
Nadine Zakkak - Collaborator - University College London ( UCL )
Oliver Mapp - Collaborator - University College London ( UCL )
Pier Lambiase - Collaborator - University College London ( UCL )
Reecha Sofat - Collaborator - University College London ( UCL )
Rohan Takhar - Collaborator - University College London ( UCL )
Rui Providencia - Collaborator - St Bartholomew's Hospital
Samuel Kim - Collaborator - University College London ( UCL )
Sheng-Chia Chung - Collaborator - University College London ( UCL )
Spiros Denaxas - Collaborator - University College London ( UCL )
Juan Pablo Casas Romero - Chief Investigator - University College London ( UCL )
HES Admitted Patient Care;NCRAS Cancer Registration Data;ONS Death Registration Data;Practice Level Index of Multiple Deprivation