Objectives To examine how the lifetime risks of atrial fibrillation and of complications after atrial fibrillation changed over time. Design Danish, nationwide, population based cohort study. Setting Population of Denmark from 1 January 2000 to 31 December 2022. Participants 3.5 million individuals (51.7% women and 48.3% men) who did not have atrial fibrillation at 45 years of age or older were followed up until incident atrial fibrillation, migration, death, or end of follow-up, whichever came first. All 362 721 individuals with incident atrial fibrillation (46.4% women and 53.6% men), but with no prevalent complication, were further followed up until incident heart failure, stroke, or myocardial infarction. Main outcome measures Lifetime risk of atrial fibrillation and lifetime risks of complications after atrial fibrillation over two prespecified periods (2000-10 v 2011-22). Results The lifetime risk of atrial fibrillation increased from 24.2% in 2000-10 to 30.9% in 2011-22 (difference 6.7% (95% confidence interval 6.5% to 6.8%)). After atrial fibrillation, the most frequent complication was heart failure with a lifetime risk of 42.9% in 2000-10 and 42.1% in 2011-22 (−0.8% (−3.8% to 2.2%)). Individuals with atrial fibrillation lost 14.4 years with no heart failure. The lifetime risks of stroke and of myocardial infarction after atrial fibrillation decreased slightly between the two periods, from 22.4% to 19.9% for stroke (−2.5% (−4.2% to −0.7%)) and from 13.7% to 9.8% for myocardial infarction (−3.9% (−5.3% to −2.4%). No evidence was reported of a differential decrease between men and women. Conclusion Lifetime risk of atrial fibrillation increased over two decades of follow-up. In individuals with atrial fibrillation, about two in five developed heart failure and one in five had a stroke over their remaining lifetime after atrial fibrillation diagnosis, with no or only small improvement over time. Stroke risks and heart failure prevention strategies are needed for people with atrial fibrillation. Permission to access the data used in this study can be obtained following approval from the Danish Health Authority.

中文翻译：

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2000 年至 2022 年间心房颤动及其并发症的终生风险的时间趋势：丹麦全国人群队列研究

目的 研究心房颤动和心房颤动后并发症的终生风险如何随时间变化。设计丹麦全国范围内的人群队列研究。设定丹麦人口为2000年1月1日至2022年12月31日。参与者对45岁或以上未患房颤的350万人（51.7%女性和48.3%男性）进行随访，直至发生房颤、迁移、死亡，或随访结束，以先到者为准。所有 362 721 名发生房颤的个体（46.4% 女性和 53.6% 男性），但没有普遍并发症，均接受进一步随访，直至发生心力衰竭、中风或心肌梗死。主要结果衡量两个预定时期（2000-10 v 2011-22）内房颤的终生风险和房颤后并发症的终生风险。结果 房颤的终生风险从 2000-10 年的 24.2% 增加到 2011-22 年的 30.9%（差异 6.7%（95% 置信区间 6.5% 至 6.8%））。心房颤动后，最常见的并发症是心力衰竭，2000-10 年的终生风险为 42.9%，2011-22 年为 42.1%（−0.8%（−3.8% 至 2.2%））。患有房颤的人失去了 14.4 年的时间，但没有发生心力衰竭。房颤后中风和心肌梗死的终生风险在这两个时期之间略有下降，中风从 22.4% 降至 19.9%（-2.5%（-4.2% 至 -0.7%）），心肌梗死从 13.7% 降至 9.8%。梗塞（-3.9%（-5.3% 至 -2.4%））。没有证据表明男性和女性之间存在差异。结论 在二十年的随访中，心房颤动的终生风险有所增加。在患有心房颤动的个体中，大约五分之二的人在心房颤动诊断后的剩余生命中出现了心力衰竭，五分之一的人在房颤诊断后的剩余生命中发生过中风，随着时间的推移，没有或只有很小的改善。心房颤动患者需要中风风险和心力衰竭预防策略。本研究中使用的数据可在丹麦卫生当局批准后获得。