Epidemiology of Atrial Fibrillation in the 21st Century

Kornej, Jelena; Börschel, Christin S.; Benjamin, Emelia J.; Schnabel, Renate B.

doi:10.1161/circresaha.120.316340

Cited by 691 publications

(384 citation statements)

References 199 publications

Supporting

Mentioning

369

Contrasting

Unclassified

Order By: Relevance

“…A systematic review of population-based studies estimated that 33.5 million individuals had AF worldwide in 2010, 1 but the figures vary according to population demographic characteristics and study design. 2 …”

Section: Introductionmentioning

confidence: 99%

Atrial fibrillation prevalence, awareness and management in a nationwide survey of adults in China

Guo

Xia

et al. 2021

Heart

103

View full text Add to dashboard Cite

ObjectiveTo determine AF prevalence and gaps in atrial fibrillation (AF) awareness and management in China.MethodsWe conducted a community-based survey of 47 841 adults (age ≥45 years) in seven geographic regions of China between 2014 and 2016. Participants underwent a structured questionnaire, a standard 12-lead ECG, physical examination and blood sampling. AF prevalence, defined by either ECG detection or self-report, was estimated according to sampling weights, non-response and age and sex distribution of the population. We used multivariable logistic regression to estimate associations among sociodemographic, clinical and geographic factors with the AF prevalence, awareness and treatment.ResultsThe weighted AF prevalence was 1.8% (95% CI 1.7% to 1.9%), but varied from 0.9% to 2.4% across geographical regions and equates to being present in an estimated 7.9 (95% CI 7.4 to 8.4) million people in China. Among men and women, the AF prevalence increased from 0.8% and 0.6% in the age group 45–54 years to 5.4% and 4.9% in the age group ≥75 years, respectively. Proportions of people who were aware of having AF decreased overall from 65.3% in 45–54 year-olds to 53.9% in ≥75 year-olds and varied between sex (men 58.5%, women 68.8%) and residency status (urban 78.3%, rural 35.3%). Only 6.0% of patients with high-risk AF received anticoagulation therapy.ConclusionsAF prevalence is higher than previously reported in China, with low awareness and large treatment gaps. Large-scale efforts are urgently needed to reduce AF adverse consequences.

show abstract

Section: Introductionmentioning

confidence: 99%

Atrial fibrillation prevalence, awareness and management in a nationwide survey of adults in China

Guo

Xia

et al. 2021

Heart

103

View full text Add to dashboard Cite

show abstract

“…6,7 This is the case of patients with atrial fibrillation (AF), who are usually elderly, with multiple comorbidities increasing their risk and making them more vulnerable. 8,9 On the other hand, previous studies showed that COVID-19 leads to vascular inflammation, contributing to hypercoagulable state and endothelial dysfunction, manifested by alteration in D-dimer and fibrinogen levels, prothrombin time and platelet count, thus increasing the risk of disseminated intravascular coagulation and venous thromboembolism (VTE). 7,[10][11][12][13] In fact, pulmonary embolism (PE) may be more frequent than expected, based on reports from autopsy studies.…”

Section: Introductionmentioning

confidence: 99%

Clinical profile and prognosis in patients on oral anticoagulation before admission for COVID‐19

Rivera‐Caravaca

Núñez‐Gil

Vivas

et al. 2020

Eur J Clin Investigation

View full text Add to dashboard Cite

Background The coronavirus disease 2019 (COVID‐19) shows high morbidity and mortality, particularly in patients with concomitant cardiovascular diseases. Some of these patients are under oral anticoagulation (OAC) at admission, but to date, there are no data on the clinical profile, prognosis and risk factors of such patients during hospitalization for COVID‐19. Design Subanalysis of the international ‘real‐world’ HOPE COVID‐19 registry. All patients with prior OAC at hospital admission for COVID‐19 were suitable for the study. All‐cause mortality was the primary endpoint. Results From 1002 patients included, 110 (60.9% male, median age of 81.5 [IQR 75‐87] years, median Short‐Form Charlson Comorbidity Index [CCI] of 1 [IQR 1‐3]) were on OAC at admission, mainly for atrial fibrillation and venous thromboembolism. After propensity score matching, 67.9% of these patients died during hospitalization, which translated into a significantly higher mortality risk compared to patients without prior OAC (HR 1.53, 95% CI 1.08‐2.16). After multivariate Cox regression analysis, respiratory insufficiency during hospitalization (HR 6.02, 95% CI 2.18‐16.62), systemic inflammatory response syndrome (SIRS) during hospitalization (HR 2.29, 95% CI 1.34‐3.91) and the Short‐Form CCI (HR 1.24, 95% CI 1.03‐1.49) were the main risk factors for mortality in patients on prior OAC. Conclusions Compared to patients without prior OAC, COVID‐19 patients on OAC therapy at hospital admission showed lower survival and higher mortality risk. In these patients on OAC therapy, the prevalence of several comorbidities is high. Respiratory insufficiency and SIRS during hospitalization, as well as higher comorbidity, pointed out those anticoagulated patients with increased mortality risk.

show abstract

“…Atrial fibrillation (AF) is the most common cardiac arrhythmia, resulting in increased risks of stroke and its related mortality and disability 1 . Anticoagulant drugs are effective drugs to prevent stroke risk in patients with AF 2 .…”

Section: Introductionmentioning

confidence: 99%

Effect of non‐recommended doses versus recommended doses of direct oral anticoagulants in atrial fibrillation patients: A meta‐analysis

Liu

Huang

et al. 2021

Clinical Cardiology

View full text Add to dashboard Cite

Background Several observational studies have shown that the inappropriate dosing use of direct oral anticoagulants (DOACs) in atrial fibrillation (AF) that does not conform to recommendations is becoming a widespread phenomenon. Therefore, we performed a meta‐analysis and systematic review to assess the effect of non‐recommended doses versus recommended doses of DOACs on the effectiveness and safety outcomes among AF patients. Methods The PubMed and Ovid databases were systematically searched to identify the relevant studies until December 2020. The effect estimates were hazard ratios (HRs) and 95% confidence intervals (CIs), which were pooled using a fixed‐effects model (I2 ≤ 50%) or a random‐effects model (I2 > 50%). Results A total of 11 studies were included in this meta‐analysis. Compared with recommended dosing of DOACs, non‐recommended low dosing of DOACs was associated with increased risks of stroke or systemic embolism (SSE, HR = 1.29, 95% CI 1.12–1.49) and all‐cause death (HR = 1.37, 95% CI 1.15–1.62), but not the ischemic stroke, myocardial infarction, gastrointestinal bleeding, intracranial bleeding, and major bleeding. Compared with recommended dosing of DOACs, non‐recommended high dosing of DOACs was associated with increased risks of SSE (HR = 1.44, 95% CI 1.01–2.04), major bleeding (HR = 1.99, 95% CI 1.48–2.68), and all‐cause death(HR = 1.38, 95% CI 1.02–1.87). Conclusion Compared with recommended dosing of DOACs, non‐recommended low dosing of DOACs was associated with increased risks of SSE and all‐cause death. Further study should confirm the findings of non‐recommended high dosing versus recommended dosing of DOACs.

show abstract

Epidemiology of Atrial Fibrillation in the 21st Century

Cited by 691 publications

References 199 publications

Atrial fibrillation prevalence, awareness and management in a nationwide survey of adults in China

Atrial fibrillation prevalence, awareness and management in a nationwide survey of adults in China

Clinical profile and prognosis in patients on oral anticoagulation before admission for COVID‐19

Effect of non‐recommended doses versus recommended doses of direct oral anticoagulants in atrial fibrillation patients: A meta‐analysis

Contact Info

Product

Resources

About