Ethnicity and stroke risk in patients with atrial fibrillation

Abstract

Despite a reduced prevalence of AF among South Asian patients, their risk of stroke is higher than for white patients or black African/Caribbean patients in association with diabetes, cardiovascular disease, and hypertension. Under-prescription of anticoagulation persists in all ethnic groups, a deficit most pronounced in the elderly. Use of the CHA2DS2VASc score would enhance optimal management in primary care.

Research into practice: understanding ethnic differences in healthcare usage and outcomes in general practice

“…8 In common with other investigators we found anticoagulation prescribing rates of 50%, and that prescribing was poorly related to the risk of stroke.…”

Cardiovascular Disease in South Asian Migrants

“…42 In Singapore, there was a higher prevalence of family history of vascular disease in SA as compared to Chinese (OR 2.17, p<0.01). 44 …”

“…39,42 Among stroke survivors in the UK, SA had nearly double the rates of DM (50.3% vs. 29.8% respectively, p=<0.001) and approximately 1/3 the rate of atrial fibrillation (11.8% vs. 34.8% respectively, p=<0.001) compared to Europids. 43 The lower rates of atrial fibrillation may be in part attributed to the younger age of SA with stroke.…”

Improving anticoagulation in atrial fibrillation: observational study in three primary care trusts

“…2,19 Attempts since 2007 by the NHS Improvement programme using the GRASP-AF software tool to improve anticoagulation had limited success. 36 About one-quarter of practices in England UK participated, and anticoagulation increased from 49.3% to 54.7% over the period 2009-2012.…”

“…[13][14][15] Fewer older patients with AF are prescribed anticoagulants, and anticoagulant use is poorly related to stroke risk. 2,16 The slope of improvement in anticoagulant use has been static for more than 10 years, improving by 1% per annum to only 50% in 2012. 14,17,18 Undertreatment at older ages persists in more recent studies.…”