Trends in the prevalence of diagnosed atrial fibrillation, its treatment with anticoagulation and predictors of such treatment in UK primary care

Abstract

Objectives: To examine trends in the prevalence of diagnosed atrial fibrillation (AF), its treatment with oral anticoagulants between 1994 and 2003, and predictors of anticoagulant treatment in 2003. Methods: Analysis of electronic data from 131 general practices (about one million registered patients annually) contributing to the DIN-LINK database. Results: From 1994 to 2003 the prevalence of ''active'' AF rose from 0.78% to 1.31% in men and from 0.79% to 1.15% in women. The proportion of patients with AF taking anticoagulants rose from 25% to 53% in men and from 21% to 40% in women. Most others received antiplatelets. The likelihood of receiving anticoagulants was greater for men and with increasing stroke risk. It decreased sharply with age after 75 years. Socioeconomic status, urbanisation and region had no influence. Non-steroidal anti-inflammatory drugs, antiplatelet drugs and ulcer healing drugs were associated with reduced likelihood of receiving anticoagulants, as were peptic ulcers, chronic gut disorders, anaemias, psychoses and poor compliance. Anticoagulant treatment was associated with several cardiovascular co-morbidities and drugs, possibly due to secondary care treatment. Nevertheless, only 56.5% of patients at very high risk of stroke were taking anticoagulants in 2003, whereas 38.2% of patients at low risk of stroke received anticoagulants. Conclusions: This study confirms previously observed trends of increasing AF prevalence and warfarin treatment. Many patients who may benefit from anticoagulation still do not receive it, whereas others at lower risk of stroke do. The lower likelihood of women receiving anticoagulants is of particular concern.

Incidence, prevalence and 1-year all-cause mortality of heart failure in Germany: a study based on electronic healthcare data of more than six million persons

“…Therefore the higher estimates in our study were to be expected compared to those from these earlier studies. Our similar prevalence estimates to those of the considerably older Rotterdam study (19) may be explained by the active screening approach for AF in the Rotterdam study which would be expected to outweigh the lower prevalence during the time period of its study conduct (26).…”

Risk Factors Affect Long-Term Compliance to Coumadin Treatment (Self-Reporting)

“…In contrast to our results, most studies showed statistically significant reduction in Coumadin use with advanced age. Coumadin usage decreased sharply after 75 years of age (DeWilde et al, 2006). The reason for that difference might be because younger AF patients do not receive Coumadin as commonly as older patients.…”

Atrial fibrillation in a primary care population: how close to NICE guidelines are we?

“…12 The prevalence of read-coded AF in 131 GPs in the DIN-LINK database increased from 0.84% to 1.49% in men and from 0.83% to 1.29% in women between 1994 to 2003. 13 Data from the General Practice Research Database showed an overall prevalence of around 1%. 14 The slightly higher prevalence rate in this survey probably relates to the level of elderly population in the catchment area.…”