BackgroundWhile some international studies have published epidemiologic overviews of atrial fibrillation (AF) for the Latin America region, detailed data at the national level are lacking. The aim of this study was to estimate the burden of disease and morbidity associated with AF in adults over 40 years of age in Argentina, Brazil, Chile, Colombia, Mexico, Peru, and Venezuela.MethodsNational health care system databases for each country in the analysis were used to identify cases of AF during 2010 based on ICD-10 codes. Patient comorbidities and treatment patterns in each country were assessed based on available data and extrapolation from relevant published information where local data were incomplete or unavailable. The prevalence of AF in each country was estimated using country-specific, national census data, and assumptions based on a review of the available literature.ResultsPatients in outpatient or hospital care represented over half of the estimated total cases of AF, of whom around 60% were treated as outpatients. Across the seven countries analyzed, 74.5% of AF cases were adults ≥60 years old. However, with increasing age, the proportion of individuals with AF receiving treatment within the national health care systems decreased overall across all seven countries. The most commonly reported comorbidities associated with AF included arterial hypertension (51%–57%), heart failure (14.5%–30%), diabetes (12%–36.5%), and stroke (3%–12.7%).ConclusionThis epidemiologic survey quantifies the scale of the challenge posed by AF to the various national health care systems in Latin America. Overall, ambulatory patients in the national health care systems carry a high risk of developing a stroke, yet a significant proportion of these patients do not receive appropriate anticoagulant therapy.

Background: Chagas' disease is the major cause of disability secondary to tropical diseases in young adults from Latin America, and around 20 million people are currently infected by T. cruzi. Heart failure due to Chagas cardiomyopathy is the main clinical presenation in Colombia. Heart failure due to Chagas' disease may respond to digoxin, diuretics and vasodilator therapy. Betaadrenoreceptor antagonism seems to protect against the increased risk of cardiac arrhythmia and sudden death due to chronic sympathetic stimulation. The aim of this study is to evaluate the effects of the selective beta-adrenergic receptor blocker Bisoprolol on cardiovascular mortality, hospital readmission due to progressive heart failure and functional status in patients with heart failure secondary to Chagas' cardiomyopathy.

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Introduction: Apixaban, a novel oral direct factor Xa inhibitor has clearly demonstrated clinical benefit in stroke or systemic embolism (SE) reduction without impacting the risk of major bleeding or intracranial hemorrhage in patients with atrial fibrillation (AF). Here we present the patient characteristics of the Latin American cohort (patients from Argentina, Brazil, Chile, Colombia, Mexico, Peru and Puerto Rico) relative to the overall clinical trial population. Methods: Patients with AF who also had at least one risk factor for stroke were randomized to receive apixaban (at a dose of 5 mg twice daily) or warfarin (target international normalized ratio, 2.0 to 3.0) in a double blind clinical trial. The study recruited from 39 countries from December 2006 through April 2010. Of the 36 countries seven were from the Latin America region: Argentina, Brazil, Chile, Colombia, Mexico, Peru, and Puerto Rico. Patient characteristics from the Latin American (LA) cohort, is presented relative to the patient characteristics of the overall trial population. Results: There were 18,201 patients in the study, of which 3,468 were from Latin America which comprised approximately 19% of the trial population. The median age was similar between the LA cohort and the total study population, 71 (IQR 64-77) and 70 (IQR 63-76) respectively. The majority of patients were male, 60.2 and 64.7% for the LA and total study populations respectively. At enrollment, 14% of the LA cohort had a previous stroke, transient ischemic attack, or systemic embolism and 19% in the overall trial population. Mean CHADS2 score at enrollment for the LA cohort was 2.1±1.1, which is the same as the overall population. When region subgroup analysis was performed, there was no statistically significant (p> 01.0) interactions between treatment effects and geographic region. Conclusions: Baseline demographic and disease characteristics data from the LA cohort are relatively similar to that of the clinical trial population for the LA cohort. Results, in terms of safety and efficacy, given the total population trial, are expected to be consistent since interaction between treatment effects and geography was not significant.

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