The prevalence of atrial fibrillation in a geographically well‐defined population in Northern Sweden: implications for anticoagulation prophylaxis

Abstract

Abstract. Andersson P, Löndahl M, Abdon N-J, Terent A (Hudiksvall Hospital, Hudiksvall; Lund University, Lund; and Uppsala University, Uppsala; Sweden). The prevalence of atrial fibrillation in a geographically well-defined population in Northern Sweden: implications for anticoagulation prophylaxis. J Intern Med 2012; 272:170-176.Objectives. The aims of this study were to evaluate the community-based prevalence of atrial fibrillation (AF) in a western society using a geographically welldefined population in the northern part of Sweden as a reference and to estimate the proportion of patients eligible for oral anticoagulation (OAC) prophylactic therapy according to the stroke risk indices CHADS 2 and CHA 2 DS 2 -VASc. Bleeding risk was assessed using the HAS-BLED score.Design. The study population was recruited from AURICULA, a Swedish national quality register for patients receiving anticoagulation treatment. All patients with the diagnosis AF in the catchment area are registered in AURICULA.Results. Of the 65 532 inhabitants in the catchment area, 1616 were diagnosed with AF (1200 cases were characterized as chronic AF). Thus, the overall prevalence of AF was 2.5%. The prevalence increased with age from 6.3% in patients over 55 years of age to 13.8% in those over 80 years. The prevalence was higher in men than in women in all age groups. Overall, 56.3% and 85.1% of the population were at high risk of stroke ( ‡2 points) according to CHADS 2 and CHA 2 DS 2 -VASc, respectively. In addition, 26.9% had an increased bleeding risk according to HAS-BLED. Conclusion.Within this large Caucasian population, we identified the highest community-based prevalence of AF to date. The prevalence was strongly associated with increasing age and male gender. Using CHA 2 DS 2 -VASc instead of CHADS 2 widened the indication for OAC prophylactic therapy of AF in this population.

Diagnosed, undiagnosed and overall atrial fibrillation research on population over 60 year-old. AFABE study

“…This fact has been also observed in few articles [13,15,30,31]. In a recent study, it has been found a slight decrease in the AF prevalence in people older than 85 years old for both, men and women [32] but in fact that article mentioned that woman never went beyond men AF prevalence.…”

“…It exists a wide range of uncertainty [20,[32][33][34] around the AF studies design. It is well known that AF prevalence is considerably higher in hospitalized patients especially in internal medicine and geriatric wards (31% for patients ≥70-year-old) [35] than in primary care [36][37][38].…”

“…In this study we have used the term "Overall AF prevalence", that have been used in epidemiologic studies by several authors [2,32,45] to refer the sum of previously undiagnosed and previously diagnosed AF prevalence. One of the most striking finding of this work has been the high overall AF prevalence that we observed.…”

Time Trends of Aspirin and Warfarin Use on Stroke and Bleeding Events in Chinese Patients With New-Onset Atrial Fibrillation

“…20% in recent decades) of anticoagulant drugs in Europe and North America. Over recent decades, warfarin use has ranged from 40% to 83% in European countries, while the annual stroke rate was 1% to 5% [22][23][24][25][26] ( e- Fig 5 ). Antithrombotic therapy use (essentially warfarin and aspirin) increased in the late 2000s in China, with large variations across practice.…”

Diagnostic accuracy and yield of screening tests for atrial fibrillation in the family practice setting: a multicentre cohort study

“…26 Indeed, we found a high level of baseline anticoagulant use in this population (95.5%), in contrast to other reports where rates of anticoagulant use were typically 50%-65%. [27][28][29][30] Some reports have suggested that anticoagulant use is increasing among patients with atrial fibrillation in the community, partly through increased uptake of non-vitamin K antagonists. [31][32][33] We cannot exclude some sampling bias in our study: participating sites may have been more focused on atrial fibrillation management and participating patients may have been more motivated to have an active role in their health care.…”