Burden of disease from atrial fibrillation in adults from seven countries in Latin America

Abstract

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.

Targeting stroke risk and improving outcomes in patients with atrial fibrillation in Latin America

“…37 In a survey of seven countries in Latin America, more than half of the patients with atrial fibrillation were receiving medical treatment, but a significant proportion of the 60% treated as outpatients were not receiving appropriate anticoagulant therapy, despite having a high stroke risk. 18 Moreover, the proportion of patients with atrial fibrillation receiving treatment within the national healthcare system decreased with increasing age across all countries. Cost and lack of health infrastructure are major barriers to care, and suboptimal care is associated with poor outcomes.…”

“…10 The GBD 2013 survey demonstrated that stroke was among the ten leading causes of disability-adjusted life-years (DALYs) in the majority of countries in Latin America and the Latin Caribbean, and was one of the five leading causes in most of them. 18 Atrial fibrillation is more common with increasing age:…”

“…18 Further, many cases of atrial fibrillation are not detected, and there is a clear need to improve the diagnosing of atrial fibrillation so as to reduce stroke risk in Latin American countries.…”

Stroke Prevention in Atrial Fibrillation: Focus on Latin America

“…18 Lifestyle-related diseases account for a significant health burden in the region, including cardiovascular disease, which is now the leading cause of death and disability among adults. 19 The average population age is also rising, leading to an elevated chronic disease burden and a heightened demand on national health systems. 20 Thus, the focus of health care resource allocation has shifted from communicable disease towards non-communicable, lifestyle-related disease in recent decades and the chronic management of these conditions.…”

Características basales, manejo de terapias antitrombóticas y pronóstico de pacientes chilenos con FA no valvular. Lecciones del Registro GARFIELD AF en Chile

“…La prevalencia de FA en Latinoamérica es similar a la reportada en grandes estudios epidemiológicos. Se estima que afecta a 1,6% de la población global, variando desde 0,4% en edades menores de 50 años hasta 8,26% sobre la edad de 80 años, con 75% de casos observados en adultos mayores de 60 años 4 . La información sobre las características de pacientes con FA no valvular chilenos es escasa.…”