Shanghai Atrial Fibrillation Registry

Composite of death, ischemic stroke, systemic embolism, myocardial infarction, major bleeding, and acute heart failure

Death due to the following reasons: Ischemic heart diseases; Hypertensive heart diseases; Other heart and vascular diseases, including myocarditis, endocarditis, pulmonary embolism, aortic aneurysm, dissecting aneurysm; Sudden, unexpected, and unwitnessed death or death of unknown cause; Ischemic stroke; Hemorrhagic stroke and non-traumatic intracranial bleeding

Death caused by: Alzheimer's disease, Parkinson's disease, other neurological diseases except vascular central nervous system causes; Diabetes mellitus; Cancers (malignant solid tumors); Chronic obstructive pulmonary disease, lower respiratory infections, and other respiratory diseases; Gastrointestinal and liver diseases; Chronic kidney diseases and other kidney diseases; Leukemia, lymphoma, and other diseases of blood system; Falls; Road injuries; Drowning and asphyxia; Self-harm; COVID-19; Other non-cardiovascular causes of death, etc.

• Neurological deficit of cerebrovascular cause that persists beyond 24 hours or is interrupted by death within 24 hours.
• Exclusion of coma due to severe brain trauma, intracranial tumor, metabolic disorder or fluid or electrolyte imbalance, peripheral neuropathy, or CNS infection.
• Not meeting criteria for subarachnoid hemorrhage, intraparenchymal hemorrhage and other hemorrhage
• With imaging findings

• Acute vascular insufficiency or occlusion of the extremities or any non-CNS organ associated with clinical, imaging, surgical/autopsy evidence of arterial occlusion.
• Exclusion of other likely mechanism, e.g., trauma, atherosclerosis, or instrumentation, etc.

• A rise of cardiac biomarker values (preferably cardiac troponin) with at least one value above the 99th percentile upper reference limit and with at least one of the following:
• Symptoms of ischemia
• ECG evidence: new ST-segment-T wave (ST-T) changes, or new left bundle branch block, or new pathological Q waves
• Imaging evidence: new loss of viable myocardium or new regional wall motion abnormality
• Angiography evidence: intracoronary thrombus

At least one of the following conditions:

• Fatal bleeding
• Symptomatic bleeding in a critical organ, such as intracranial, intraspinal, intraocular, retroperitoneal, intra-articular or pericardial, or intramuscular with compartment syndrome
• Bleeding causing a fall in hemoglobin level of 20 g/L or more or leading to transfusion of two or more units of whole blood or red cells.

• Hospitalization, or emergency department visit requiring treatment with infusion therapy, for a clinical syndrome that presents with multiple signs and symptoms consistent with cardiac decompensation or inadequate cardiac pump function.
• Evidence in the doctor's notes that the reason for this hospitalization, or emergency department visit, was heart failure.
• Evidence of signs and symptoms: increasing or new onset shortness of breath, edema, paroxysmal nocturnal dyspnea, orthopnea, and hypoxia
• Include acute decompensated HF with preserved, mid-range, and reduced left ventricular ejection fraction.
• If a patient was diagnosed and treated for HF in an outpatient setting without infusion therapy for decompensated HF, such condition was not considered an outcome.

Medical cost related to: AF and non-AF diseases; at emergency department, outpatient and inpatient.