Global, regional, and national burden of atrial fibrillation and its association with alcohol consumption: age, sex, regional, and SDI differences-an analysis of the Global Burden of Disease Study 2021.

BACKGROUND: Atrial fibrillation (AF) is a leading cause of mortality and disability globally. While trends in AF-related deaths are well-documented, the influence of alcohol consumption and regional disparities, particularly across different Socio-Demographic Index (SDI) regions, remains underexplored. OBJECTIVE: To analyze global and regional trends in AF-related mortality from 1990 to 2021, focusing on age, sex, and the impact of alcohol consumption across regions and SDI. METHODS: Data from the Global Burden of Disease (GBD) Study 2021 were used to assess age- and sex-specific AF mortality rates in 204 countries. Mortality trends were analyzed from 1990 to 2021, with attention to age group (30-44, 45-64, 65-84, 85-94, 95 + years) and sex. The impact of alcohol on AF-related mortality was examined by WHO regional classifications. RESULTS: AF-related mortality increased globally in both men and women, with a higher rate in women. Female mortality increased notably in the 90-94 and 95 + age groups, while male mortality surged in the 30-44 and 85+ age groups. Regionally, Greenland showed a decline in male mortality, while Sweden's rates rose. In China, both male and female mortality rates decreased. Alcohol consumption had a significant impact on AF mortality in Europe and the Americas, with smaller effects in Africa, Southeast Asia, and the Eastern Mediterranean. CONCLUSION: The global burden of AF-related mortality is rising, with significant age, sex, and regional disparities. Alcohol consumption contributes notably to AF deaths in Europe and the Americas, highlighting the need for targeted interventions in high-risk regions. These findings emphasize the importance of addressing alcohol-related AF mortality through region-specific public health strategies.