Prevalence of atrial fibrillation in the Italian elderly population and projections from 2020 to 2060 for Italy and the European Union: the FAI Project

Abstract

Aims To estimate prevalence of atrial fibrillation (AF) in a representative sample of the Italian elderly population, projecting figures for Italy and the European Union. Methods and results A cross-sectional examination of all subjects aged 65+ years from three general practices in Northern, Central, and Southern Italy started in 2016. Participants were administered a systematic and an opportunistic screening, followed by clinical and electrocardiogram confirmation. The study sample included 6016 subjects. Excluding 235 non-eligible, among the remaining 5781 participation was 78.3%, which left 4528 participants (mean age 74.5 ± 6.8 years, 47.2% men). Prevalence of AF was 7.3% [95% confidence intervals (CI) 6.6–8.1], higher in men and with advancing age (6.6% from systematic plus 0.7% from opportunistic screening). Using prevalence figures, Italian elderly having AF in 2016 were estimated at ∼1 081 000 (95% CI 786 000–1 482 000). Considering stable prevalence, this number will increase by 75% to ∼1 892 000 in 2060 (95% CI 1 378 000–2 579 000). European Union elderly having AF in 2016 were estimated at ∼7 617 000 (95% CI 5 530 000–10 460 000), increasing by 89% to ∼14 401 000 in 2060 (95% CI 10 489 000–19 647 000). In 2016, subjects aged 80+ years represented 53.5% of cases in Italy and 51.2% in the European Union; in 2060, 69.6% and 65.2%, respectively. Conclusions Our findings indicate a high burden of AF in coming decades, especially among the oldest-old, who carry the higher AF-related risk of stroke and medical complications.

A multicenter prospective cohort study to investigate the effectiveness and safety of apixaban in Japanese elderly atrial fibrillation patients (J‐ELD AF Registry)

“…Many of the Japanese AF patients are of advanced age (≥75 years) and thus at high risk of stroke and systemic embolism . The same situation is predicted in the world wide in the near future …”

“…3 The same situation is predicted in the world wide in the near future. 6,7 While warfarin, a vitamin K antagonist, has mainly been used as an oral therapeutic agent in AF for stroke prevention for more than 50 years, its application in elderly patients is not common because of its instability of effect and high incidence rate of serious bleeding. 8,9 Several direct oral anticoagulants (DOACs) have been developed as alternatives to warfarin 10 and are currently available worldwide.…”

Inflammatory and lipid regulation by cholinergic activity in epicardial stromal cells from patients who underwent open‐heart surgery

“…It is estimated to increase by 22% in elderly population. 1 This arrhythmia is associated with long-term mortality, morbidity and higher risk of stroke. The responsible factors for the AF incidence and perpetuation can be classified into different mechanisms, which give this disease a multi-factorial condition.…”

Prevalence of Atrial Fibrillation Subtypes in Italy and Projections to 2060 for Italy and Europe

“…We have already reported the estimates and projections to 2060 for total AF. 3 Italian older persons with AF in 2016 were estimated at approximately 1.1 million, projected to increase to approximately 1.9 million by the year 2060. Estimates for European Union were approximately 7.6 million AF patients in 2016, projected to approximately 14.4 million by 2060.…”

“…Methods, limits, and results of these methods have already been reported in detail. 3 Both screening procedures were followed, in positive cases, by a direct diagnostic assessment, in their own primary care practice, to confirm or not the suspicion of AF. This included medical history, a clinical examination about possible symptoms of AF, evaluation of radial pulse, detection of pacemaker or implantable cardioverter-defibrillator, and the recording of a 12-lead ECG.…”