Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. May 26, 2025; 17(5): 105919
Published online May 26, 2025. doi: 10.4330/wjc.v17.i5.105919
National adult mortality trends due to chronic kidney disease-related atrial fibrillation in the United States from year 2011-2020
Muhammad Abdullah Naveed, Faizan Ahmed, Ahila Ali, Sherif Eltawansy, Zaima Afzaal, Bazil Azeem, Muhammad Kashan, Omar Kamel, Hritvik Jain, Mushood Ahmed, Kainat Aman, Hira Zahid, Rabia Iqbal, Aman Ullah, Muhammad Naveed Zafar, Pawel Lajczak, Ogechukwu Obi, Raheel Ahmed
Muhammad Abdullah Naveed, Ahila Ali, Muhammad Kashan, Hira Zahid, Rabia Iqbal, Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi 74200, Pakistan
Faizan Ahmed, Department of Internal Medicine, Duke University Hospital, Durham, NC 27710, United States
Sherif Eltawansy, Department of Internal Medicine, Jersey Shore University Medical Center, Neptune, NJ 07753, United States
Zaima Afzaal, Department of Internal Medicine, Ameer-ud-Din Medical College, Lahore 54000, Pakistan
Bazil Azeem, Department of Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi 74900, Pakistan
Omar Kamel, Department of Physical Therapy, South Valley University, South Valley 83523, Egypt
Hritvik Jain, Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur 400022, India
Mushood Ahmed, Department of Internal Medicine, Rawalpindi Medical University, Rawalpindi 74200, Pakistan
Kainat Aman, Department of Internal Medicine, Batterjee Medial College, Jeddah 21442, Saudi Arabia
Aman Ullah, Department of Internal Medicine, SSM Health St Louis University, St Louis, 63104, United States
Muhammad Naveed Zafar, Department of Internal Medicine, Liaquat Institute of Medical and Health Sciences, Thatta 73130, Pakistan
Pawel Lajczak, Medical University of Silesia, Medical University of Silesia in Katowice, Katowice 40-055, Poland
Ogechukwu Obi, Department of Internal Medicine, New York Institute of Technology: College of Osteopathic Medicine, Westbury, NY 11568, United States
Raheel Ahmed, Department of Cardiology, National Heart and Lung Institute, Imperial College London, London SW3 6 LY, United Kingdom
Author contributions: Azeem B, Kashan M, Kamel O, Jain H, Ahmed M, Aman K, Zahid H, Iqbal R, Ullah A, Naveed Zafar M, Lajczak P, Obi O, and Ahmed R carried out the data curation; Abdullah Naveed M, Ahmed F, Ali A, Eltawansy S, Kashan M, Jain H, Ullah A, and Naveed Zafar M contributed to the validation of the manuscript; Abdullah Naveed M, Ahmed F, Ali A, Eltawansy S, Kashan M, Jain H, Ahmed M, Aman K, Zahid H, and Iqbal R contributed to the visualization of the manuscript; Abdullah Naveed M, Ahmed F, Ali A, Eltawansy S, Kashan M, and Jain H contributed to the formal analysis of the manuscript; Abdullah Naveed M, Ahmed F, Ali A, Eltawansy S, Ullah A, Naveed Zafar M, Kashan M, Jain H, Ahmed M, Aman K, Zahid H, Iqbal R, Ullah A, and Naveed Zafar M wrote the original draft; Abdullah Naveed M, Ahmed F, Ali A, and Eltawansy S contributed to the conceptualization and methodology of the manuscript; Abdullah Naveed M, Ahmed F, Ali A, Eltawansy S, Ullah A, Naveed Zafar M, Lajczak P, Obi O, Ahmed R, Azeem B, Kamel O, and Afzaal Z conducted software analysis; Ahmed M, Aman K, Zahid H, and Iqbal R contributed to the investigation; Lajczak P, Obi O, Ahmed R, Azeem B, Kamel O, and Afzaal Z: wrote, reviewed and edited; and all authors thoroughly reviewed and endorsed the final manuscript.
Institutional review board statement: Institutional review board was waiver as study utilized national database with deidentified information and with public access.
Informed consent statement: Researchers are not required to obtain explicit consent from participants as a national database was used with deidentified patient information.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The authors confirm that the data supporting the findings of this study are available within the article (Tables 1-8).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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 and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sherif Eltawansy, Assistant Professor, Department of Internal Medicine, Jersey Shore University Medical Center, 1945 NJ-33, Neptune, NJ 07753, United States. alanine40@hotmail.com
Received: February 11, 2025
Revised: March 26, 2025
Accepted: May 7, 2025
Published online: May 26, 2025
Processing time: 102 Days and 2.4 Hours
Abstract
BACKGROUND

Atrial fibrillation (AF) associated with chronic kidney disease (CKD) is a prevalent condition in the United States, significantly impacting global morbidity and mortality. Understanding temporal patterns in AF-related mortality among CKD patients is crucial for effective clinical and public health strategies.

AIM

To investigate AF-CKD comorbidity and mortality on the national level.

METHODS

Death certificates from the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research database spanning 2011-2020 were analyzed to investigate AF-related CKD mortality in adults aged 35 to 85 or more years. Age-adjusted mortality rates (AAMRs) per 100000 persons and annual percent change (APC) were calculated, stratified by year, sex, race/ethnicity, and geographic region.

RESULTS

A total of 110733 deaths occurred among adults (aged 35-85 or more years) related to AF associated with CKD in the United States. Overall AAMR declined from 8.1 in 2011 to 5.5 in 2014 (APC: -14.89; 95% confidence interval (CI): -30.44 to -4.06), followed by an increase to 10.3 in 2020 (APC: 9.91; 95%CI: 6.1-19.62). Men had higher AAMRs than women (men: 7.6, 95%CI: 7.6-7.7). Non-Hispanic White adults had the highest AAMR (7.8), followed by non-Hispanic Black (5). States in the top 90th percentile had approximately four times higher AAMRs than those in the lower 10th percentile. AAMR also varied by region (Midwest: 7.6, West: 6.7, Northeast: 6.3, South: 5.6), with nonmetropolitan areas exhibiting higher AF-associated CKD mortality.

CONCLUSION

Temporal trends in AF-related mortality among CKD patients showed fluctuations over the study period, with notable disparities across demographic and geographic factors. Targeted interventions are warranted to mitigate the burden of AF associated with CKD and reduce mortality rates in the United States.

Keywords: Atrial fibrillation; Chronic kidney disease; Mortality; Risk factors; Disparities

Core Tip: Chronic kidney disease (CKD) could contribute to atrial fibrillation with increased mortality; our study investigates this correlation using the Centers for Disease Control’s national database over the last 2 decades. The age-adjusted mortality rate for CKD-related atrial fibrillation deaths in adults decreased from 2011 to 2014, followed by an increase from 2014 to 2020. Study noticed a variation in mortality based on gender (higher in men), race (higher in non-Hispanic White patients), Midwest states (Indiana, and Minnesota), and Nonmetropolitan areas. That result illustrates different disparities in two correlated common chronic morbidity that would guide healthcare providers and policymakers work on achieving more efficient and equitable healthcare system.