Evidence map›Paper›PMID 40662442›Full record

ArticleClinical cardiology2025

Trends in Atrial Fibrillation-Related Mortality Among Older Adults With Obstructive Sleep Apnea in the United States, 1999-2020.

Ibrahim Nagmeldin Hassan, Mohamed Ibrahim, Siddig Yaqub, Muhsin Ibrahim, Haythem Abdalla, Ghada Aljaili, Wafa Osman, Nagmeldin Abuassa, Hamza Ashraf, Maryam Shoukat

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ibrahim Nagmeldin HassanUniversity of Khartoum Faculty of Medicine, Khartoum, Sudan.ORCID https://orcid.org/0009-0003-3331-8138
Mohamed IbrahimAl-Neelain University Faculty of Medicine, Khartoum, Sudan.
Siddig YaqubKarary University, Faculty of Medicine, Khartoum, Sudan.
Muhsin IbrahimSudan University of Science and Technology, Faculty of Medicine, Khartoum, Sudan.
Haythem AbdallaUniversity of Bahri, Faculty of Medicine, Khartoum, Sudan.
Ghada AljailiOmdurman Islamic University, Faculty of Medicine, Khartoum, Sudan.
Wafa OsmanUniversity of Bahri, Faculty of Medicine, Khartoum, Sudan.
Nagmeldin AbuassaUniversity of Khartoum Faculty of Medicine, Khartoum, Sudan.
Hamza AshrafAllama Iqbal Medical College, Lahore, Pakistan.
Maryam ShoukatGujranwala Medical College, Gujranwala, Pakistan.

Funding

The authors received no specific funding for this work.
6 · The paper itself

Abstract

backgroundAtrial fibrillation (AF) and obstructive sleep apnea (OSA) frequently coexist and synergistically increase cardiovascular risk. While their pathophysiologic interplay is well established, national data on mortality trends involving both conditions are scarce.

methodsWe analyzed mortality data from the CDC WONDER platform (1999-2020), including adults aged ≥ 25 years with AF (ICD-10 I48.x) listed as the underlying cause of death and OSA (G47.33) as a contributing condition. Age-adjusted mortality rates (AAMRs) and average annual percent changes (AAPCs) were calculated using Joinpoint regression, stratified by sex, race/ethnicity, urbanization, region, and age.

resultsA total of 32,142 AF-related deaths with OSA were identified. The overall AAMR was 0.60 per 100 000, increasing significantly over time (AAPC: 16.69%, 95% CI: 15.62-17.77). Mortality rose across all demographic groups, with the steepest increases among adults ≥ 85 years (AAPC: 19.40%), females (AAPC: 17.77%), rural residents (AAPC: 17.51%), and White individuals (AAPC: 16.95%). Regionally, the Midwest (AAMR: 0.79) and West (0.72) had the highest rates. State-level variation ranged from 1.90 (Oregon) to 0.19 (Mississippi). Despite lower absolute AAMRs among Hispanic and Asian populations, significant upward trends were observed. OSA appears frequently underdiagnosed or untreated in high-risk groups, potentially exacerbating AF mortality.

conclusionsAF-related mortality involving OSA has risen sharply over the past two decades, outpacing many other cardiovascular trends. These findings underscore the urgent need for integrated AF-OSA screening and treatment pathways, with attention to underserved and disproportionately affected populations.

Indexed as

Atrial FibrillationSleep Apnea, ObstructiveAdultAgedAged, 80 and overCause of DeathFemaleHumansMaleMiddle AgedRetrospective StudiesRisk AssessmentRisk FactorsSurvival RateTime FactorsUnited Statesage‐adjusted mortality rateatrial fibrillationCDC WONDERmortality trendsobstructive sleep apneaolder adults

Identifiers

PMID40662442
PMCPMC12261039

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.