Abstract 4147474: Global and regional burden of alcohol-related atrial fibrillation from 1990 to 2021: An analysis of GBD study 2021

Background and Aims: Atrial fibrillation constitutes a major global public health issue, with its epidemiological patterns having changed significantly over the past decades. In this study, we aimed to analyze trends of mortality due to alcoholic atrial fibrillation from 1990-2021, including identifying the patterns in age-standardized death rates (ASDR), years of life lost (YLL), and disability-adjusted life years (DALY) over time, and raising awareness about the global health burden of alcoholic atrial fibrillation. Methods: Data on alcohol-related atrial fibrillation was extracted from the Global Burden of Diseases 2021 study, including ASDR, YLL, and DALY from 1990 to 2021. The dataset was globally divided and categorized by continents and World Bank income levels. Joinpoint regression analysis was performed to determine average annual percentage changes (AAPC) from 1990 to 2021. Results: Globally, the Age standardized death rates (ASDR) for alcohol-related atrial fibrillation had a constant trend from 1990-2021. The ASDR was determined to be 0.15 (95% UI 0.1-0.2) both in 1990 and 2021 (AAPC=-0.014; 95% CI -0.014 to -0.036). Although the overall trend is constant, a considerable spike in mortality rates was observed from 2000-2010 (APC=0.38). Globally, the disability-adjusted life-years (DALYs) and the age standardized years of life lost (YLL) have remained fairly constant with AAPCs of -0.052 (95% CI -0.063 to -0.036) and -0.07 (95% CI -0.098 to -0.047), respectively. In continent wise analysis, North America and Asia had intermittent spikes in ASDRs while Europe and Africa showed a constant trend throughout the analysis. From 1990 to 2021, North America had an AAPC of 1.26 (95% CI 1.23-1.29), showing a deviation from global trend with an incline. Similarly, Asia had an increasing trend with AAPC of 0.58 (95% CI 0.55-0.6). Africa also had a minutely increasing trend from 1990 to 2021 with an AAPC of 0.36 (95% CI 0.33 to 0.38). According to World Bank income levels, high-income countries had the highest death rates, followed by upper-middle income, lower-middle income and low-income countries in descending order. Conclusions: Although trends in the burden of alcohol-related atrial fibrillation have varied globally, the net change in years of life lost (YLL) and age-standardized death rates (ASDR) from 1990 to 2021 have been minimal. The data highlights the need for further research, to develop specific strategies that are targeted at specific populations.