Atrial fibrillation prevalence revisited.
Leif Friberg,Lennart Bergfeldt +1 more
TLDR
The objective was to determine the prevalence of atrial fibrillation in Sweden, irrespective of type and to what extent patients with AF receive adequate stroke prophylaxis.Abstract:
Background
The estimate of 0.4–1.0% prevalence of atrial fibrillation in the most recent American guidelines is based mainly on studies including patients with permanent atrial fibrillation (AF), although recent evidence shows that the stroke risk is similar with paroxysmal and persistent AF. Our objective was to determine the prevalence of AF in Sweden, irrespective of type and to what extent patients with AF receive adequate stroke prophylaxis.
Method
Retrospective study of patients with a clinical diagnosis of atrial fibrillation between 2005 and 2010 in the national Swedish Patient Register matched with data from the National Prescribed Drugs Register.
Results
We identified 307 476 individuals with a diagnosis of atrial fibrillation. Of these, 209 141 were still alive on the last day of the inclusion period, signifying a prevalence of clinically diagnosed AF in Sweden of 2.9% of the total adult (≥20 years) population. Only 42% of them had purchased an oral anticoagulant within 6 months of the first presentation with AF during the study period. Those at the highest risk of stroke were those least likely to receive anticoagulant treatment. Undertreatment was common amongst women and individuals >80 years, whilst overtreatment was common amongst young men without risk factors.
Conclusion
The prevalence of atrial fibrillation is at least 2.9% of the Swedish adult population, not counting ‘silent atrial fibrillation’. The official US figures probably underestimate the magnitude of the problem by a factor of 3–5. More than 80% had risk factors motivating anticoagulation therapy.read more
Citations
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Journal ArticleDOI
Validation of clinical classification schemes for predicting stroke: results from the national registry of atrial fibrillation☆
Brian F. Gage,Amy D. Waterman,William D. Shannon,Michael Boechler,Michael W. Rich,Martha J. Radford +5 more
TL;DR: The 2 existing classification schemes and especially a new stroke risk index, CHADS, can quantify risk of stroke for patients who have AF and may aid in selection of antithrombotic therapy.
Journal ArticleDOI
Epidemiology of atrial fibrillation: European perspective.
TL;DR: The number of patients with AF in 2030 in Europe will be 14–17 million and the number of new cases of AF per year at 120,000–215,000, which will have major public health implications.
Journal ArticleDOI
Global epidemiology of atrial fibrillation
TL;DR: The available data on the global prevalence, risk factors, management, financial costs, and clinical burden of AF are discussed, and the current worldwide inadequacy of its treatment is highlighted.
Journal ArticleDOI
Mass Screening for Untreated Atrial Fibrillation The STROKESTOP Study
TL;DR: In this article, the prevalence of untreated atrial fibrillation (AF) in a systematic screening program using intermittent ECG recordings among 75- to 76-year-old individuals and to study the feasibility of initiating protective oral anticoagulant (OAC) treatment was defined.
Journal ArticleDOI
Screening for Atrial Fibrillation: A Report of the AF-SCREEN International Collaboration
Ben Freedman,John Camm,Hugh Calkins,Jeff S. Healey,Mårten Rosenqvist,Jiguang Wang,Christine M. Albert,Craig S. Anderson,Sotiris Antoniou,Emelia J. Benjamin,Giuseppe Boriani,Johannes Brachmann,Axel Brandes,Tze-Fan Chao,David Conen,Johan Engdahl,Laurent Fauchier,David A Fitzmaurice,Leif Friberg,Bernard J. Gersh,David J. Gladstone,Taya V. Glotzer,Kylie Gwynne,Graeme J. Hankey,Joseph Harbison,Graham S. Hillis,Mellanie True Hills,Hooman Kamel,Paulus Kirchhof,Peter R. Kowey,Derk Krieger,Vivian W Y Lee,Lars-Åke Levin,Gregory Y.H. Lip,Trudie Lobban,Nicole Lowres,Georges H. Mairesse,Carlos Martinez,Lis Neubeck,Jessica Orchard,Jonathan P. Piccini,Katrina Poppe,Tatjana S. Potpara,Helmut Puererfellner,Michiel Rienstra,Roopinder K. Sandhu,Renate B. Schnabel,Chung-Wah Siu,Steven R. Steinhubl,Jesper Hastrup Svendsen,Emma Svennberg,Sakis Themistoclakis,Robert G. Tieleman,Mintu P. Turakhia,Arnljot Tveit,Steven B Uittenbogaart,Isabelle C. Van Gelder,Atul Verma,Rolf Wachter,Bryan P. Yan +59 more
TL;DR: A strong case for AF screening now is provided while recognizing that large randomized outcomes studies would be helpful to strengthen the evidence base.
References
More filters
Journal ArticleDOI
Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study.
Alan S. Go,Elaine M. Hylek,Kathleen A. Phillips,Yuchiao Chang,Lori E. Henault,Joe V. Selby,Daniel E. Singer +6 more
TL;DR: It is confirmed that atrial fibrillation is common among older adults and provides a contemporary basis for estimates of prevalence in the United States.
Journal ArticleDOI
Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation.
TL;DR: In this article, a simple stroke risk stratifi cation schema, based on a risk factor approach, provides some improvement in predictive value for TE over the CHADS 2 schema, with low event rates in low-risk subjects and only a small proportion of subjects into the intermediate-risk category.
Journal ArticleDOI
Validation of Clinical Classification Schemes for Predicting Stroke: Results From the National Registry of Atrial Fibrillation
Brian F. Gage,Amy D. Waterman,William D. Shannon,Michael Boechler,Michael W. Rich,Martha J. Radford +5 more
TL;DR: The 2 existing classification schemes and especially a new stroke risk index, CHADS, can quantify risk of stroke for patients who have AF and may aid in selection of antithrombotic therapy.
Journal ArticleDOI
Impact of Atrial Fibrillation on the Risk of Death The Framingham Heart Study
Emelia J. Benjamin,Philip A. Wolf,Ralph B. D'Agostino,Halit Silbershatz,William B. Kannel,Daniel Levy +5 more
TL;DR: There was a significant AF-sex interaction: AF diminished the female advantage in survival and AF remained significantly associated with excess mortality, with about a doubling of mortality in both sexes in subjects free of valvular heart disease and preexisting cardiovascular disease.
Journal ArticleDOI
2012 focused update of the ESC Guidelines for the management of atrial fibrillation: An update of the 2010 ESC Guidelines for the management of atrial fibrillation * Developed with the special contribution of the European Heart Rhythm Association
A. John Camm,Jeroen J. Bax,Robert Fagard,Christian Funck-Brentano,David Hasdai,Theresa McDonagh,Bogdan A. Popescu,Udo Sechtem,Stephan Windecker,Ottavio Alfieri,Annalisa Angelini,Andreas Goette,Robert Hatala,Philippe Kolh,Piotr Ponikowski,Frans H. Rutten,Isabelle C. Van Gelder +16 more
TL;DR: An update of the 2010 ESC Guidelines for the management of atrial fibrillation with the special contribution of the European Heart Rhythm Association is developed.
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