Prevalence, clinical correlates and treatment of permanent atrial fibrillation among the elderly: insights from the first prospective population-based study in rural Greece

Ninios, Ilias; Bogossian, Harilaos; Zarse, Markus; Lazaridou, Fotini; Dimitriadis, Kyriakos; Ninios, Vlasios; Lemke, Bernd; Louridas, George

doi:10.1007/s11239-009-0422-3

Cited by 8 publications

(7 citation statements)

References 33 publications

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“…Overall, AF was found to be higher among those with advanced age (19-22, 24-26, 28-30), male gender (19)(20)(21)(22)30), hypertension (19,21,24,28,31), diabetes (19,24,28), prior myocardial infarction (16,21,26,28,30), prior stroke (21,24,29), obesity (26,29), hyperlipidemia/hypercholesterolemia (19,29,30), alcohol consumption (16,26,28), and heart failure (24). Furthermore, ECG and echocardiographic fi ndings of left ventricular hypertrophy (22,26,28,30), low left ventricular ejection fraction (28), left bundle branch block (16), left atrial diameter (30), peak early rapid fi lling wave velocity (30), myocardial ischemia (21), and ventricular premature beats (21) were found to be associated with AF. Only six studies (19,24,26,(28)(29)…”

Section: Resultsmentioning

confidence: 96%

“…We noted signifi cant associations between rural AF and increasing age (19-22, 24-26, 28-30). Male gender (19)(20)(21)(22)30), hypertension (19,21,24,28,31), diabetes (19,24,28), prior myocardial ischemia/infarction (16,21,26,28,30), alcohol consumption (16,26,28), prior stroke (21,24,29), and obesity (26,29) were also associated with AF. What is apparent from our review is that none of the studies reported all the risk factors or comorbidities that may be associated with AF.…”

Section: Discussionmentioning

confidence: 99%

“…An increase in AF risk for regular alcohol usage or higher rates of alcohol intake was noted (16,26,28). However, one study found that not consuming alcohol was a signifi cant predictor of AF (21). Previous studies have documented the cardiovascular benefi ts of low to moderate alcohol intake (39); however, heavy drinking has also been shown to be a strong risk factor for the development of AF (40)(41)(42).…”

Section: Discussionmentioning

confidence: 99%

“…Th ere were 7 prospective cohort studies and 11 cross-sectional studies (Table 1) (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Participants were recruited either from population-based screening programs, annual health checks, or general practitioner clinics.…”

Section: Methodsmentioning

confidence: 99%

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Review of Screening Studies for Atrial Fibrillation in Rural Populations of 11 Countries

Gavino

McLachlan

2017

Baylor University Medical Center Proceedings

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Atrial fibrillation (AF) is a common cardiac arrhythmia, and pathological burden can be influenced by environmental factors. The rural environment may influence the burden of AF, although no systematic review studies have been conducted to address this issue. We performed a systematic review of AF screening studies conducted in rural global populations to determine the burden, risk factors, and screening methods surrounding AF in these settings. Out of the 1792 articles gathered from a keyword search of medical databases and reference lists, 18 publications from 11 countries were included in our analysis. The pooled prevalence of AF across the studies was 2.05% (95% confidence interval, 1.97%-2.13%) and ranged from 0.3% to 10.87%. Only one study utilized a handheld electrocardiogram to screen AF, while the rest used the 12-lead electrocardiogram. AF risk factors reported across studies varied and included increasing age, male gender, hypertension, diabetes, prior myocardial infarction or stroke, obesity, hyperlipidemia/hypercholesterolemia, alcohol consumption, and heart failure. However, none of the studies assessed all risk factors. We suggest that future research on AF in rural communities examine a complete checklist of AF risk factors to better understand their influence on AF burden and development. This will aid in understanding rural prevention strategies and the management of detected AF cases specific to rural areas. At present, the burden of AF in rural communities is poorly understood and has been underreported.

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Section: Resultsmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Review of Screening Studies for Atrial Fibrillation in Rural Populations of 11 Countries

Gavino

McLachlan

2017

Baylor University Medical Center Proceedings

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“…A cross-sectional study of 1178 patients with AF attending 12 emergency departments (EDs) in Spain found that 89% of the patients not taking anticoagulants had indications for anticoagulation, with 63% of these patients having two or more risk factors (19). The pattern of underuse of warfarin recurs in Switzerland (20), Japan (21) and Greece (22).…”

Section: Anticoagulants and The Underuse Of Warfarinmentioning

confidence: 99%

Treatment pathways for patients with atrial fibrillation

Hodgkinson

Taylor

Hobbs

2011

International Journal of Clinical Practice

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BackgroundAtrial fibrillation (AF) is a common rhythm disorder and the most common chronic arrhythmia. AF is associated with increased morbidity and mortality (1), and, in particular, is a major independent risk factor for stroke (2), particularly in older patients. The prevalence of AF in the UK is more than 12⁄ 1000, but this increases to at least 10% in people aged 85 years and over (3) or to 16% according to recent data (4).Atrial fibrillation represents a challenging arrhythmia. A rational approach to management of the individual case depends on careful assessment of the temporal pattern of the arrhythmia, any associated cardiovascular disease and any particular features suggesting the advisability or risks of specific treatment regimens. The nature of an arrhythmia and of individual patient factors changes over time, requiring a flexible approach to long-term treatment that may be defined only after months or years (5). In particular, key considerations are the use of anticoagulants and ⁄ or antiplatelets as antithrombotic therapy, and the pursuance of a rate-or rhythm-control approach. SUMMARYBackground: Although there has been growing concordance over what constitutes best practice in recent guidelines for treatment of atrial fibrillation (AF), notably regarding anticoagulant use, it remains unclear whether patients are being treated accordingly. Aims: The aims of this study were to explore the pattern of treatment pathways -i.e. how patients are treated over time -for patients with AF, and to test the hypothesis that comparative to patients in lower stroke-risk categories (as measured by CHADS 2 score), patients with higher CHADS 2 scores are less likely to discontinue anticoagulant therapy or, if not started on anticoagulant treatment, more likely to be transferred to anticoagulant therapy, in keeping with guideline recommendations. Setting: A total of 67,857 patients with a diagnosis of AF in practices registered with the General Practice Research Database. Methods: A series of possible treatment pathways were identified, and for each initial treatment, we estimated the probability of treatment change and the average time that a patient newly diagnosed with AF spent on a particular treatment, projected across 5 years and stratified by CHADS 2 score. Results: There was no relationship between CHADS 2 score and maintenance or discontinuation of particular approaches to antithrombotic treatment. While those beginning on antiplatelet therapy were more likely to change treatment than those on anticoagulants (approximately 60% vs. 50% within the first year), as much as one-third of treatment time of all those starting on a therapeutic approach involving anticoagulants featured no use of anticoagulants (either as monotherapy or in combination) over the 5-year period, and whether treatment was discontinued or maintained did not vary by CHADS 2 score. No difference was found in treatment pathways controlling for post-2002 diagnoses as against the whole sample. Conclusions: Although there is more evidence of tr...

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Anticoagulant therapy is prescribed less often in paroxysmal atrial fibrillation regardless of thromboembolic risk: Results from the Registry of Atrial Fibrillation To Investigate New Guidelines (RAFTING)

Pipilis

Farmakis

Kaliambakos

et al. 2014

International Journal of Cardiology

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Prevalence, clinical correlates and treatment of permanent atrial fibrillation among the elderly: insights from the first prospective population-based study in rural Greece

Cited by 8 publications

References 33 publications

Review of Screening Studies for Atrial Fibrillation in Rural Populations of 11 Countries

Review of Screening Studies for Atrial Fibrillation in Rural Populations of 11 Countries

Treatment pathways for patients with atrial fibrillation

Anticoagulant therapy is prescribed less often in paroxysmal atrial fibrillation regardless of thromboembolic risk: Results from the Registry of Atrial Fibrillation To Investigate New Guidelines (RAFTING)

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