Atrial fibrillation prevalence revisited.
Atrial fibrillation prevalence revisited.
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DOI：
10.1111/joim.12114
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发表时间：
2013-11-01
影响因子：
11.1
通讯作者：
Bergfeldt, L
中科院分区：
文献类型：
--
作者：
Friberg, L;Bergfeldt, L
背景技术背景：在最新的美国指南中，房颤患病率估计为0.4-1.0%，主要是基于包括永久性房颤（AF）患者的研究，尽管最近的证据表明阵发性和持续性AF的卒中风险相似。我们的目的是确定瑞典AF的患病率，无论房颤类型和程度如何，房颤患者均接受了充分的卒中预防。2005年至2010年瑞典国家患者登记册中临床诊断为房颤的患者的回顾性研究结果：我们确定了307476例诊断为房颤的患者。其中，209141例患者在入选期的最后一天仍然存活，表明瑞典临床诊断的AF患病率为总成人（≥ 20岁）人群的2.9%。在研究期间，只有42%的患者在首次出现房颤的6个月内购买了口服抗凝剂。那些中风风险最高的人是那些最不可能接受抗凝治疗的人。治疗不足是常见的妇女和个人> 80 years，而过度治疗是常见的年轻男子之间没有风险factors.CONCLUSION：心房颤动的患病率至少是2.9%的瑞典成年人口，不算'沉默性心房颤动'。美国官方数据可能低估了问题的严重性，低估了3-5倍。超过80%的患者存在促发抗凝治疗的风险因素。
BACKGROUND: The estimate of 0.4-1.0% prevalence of atrial fibrillation in the most recent American guidelines is based mainly on studies including patients with permanent atrial fibrillation (AF), although recent evidence shows that the stroke risk is similar with paroxysmal and persistent AF. Our objective was to determine the prevalence of AF in Sweden, irrespective of type and to what extent patients with AF receive adequate stroke prophylaxis.METHOD: Retrospective study of patients with a clinical diagnosis of atrial fibrillation between 2005 and 2010 in the national Swedish Patient Register matched with data from the National Prescribed Drugs Register.RESULTS: We identified 307476 individuals with a diagnosis of atrial fibrillation. Of these, 209141 were still alive on the last day of the inclusion period, signifying a prevalence of clinically diagnosed AF in Sweden of 2.9% of the total adult (≥20years) population. Only 42% of them had purchased an oral anticoagulant within 6months of the first presentation with AF during the study period. Those at the highest risk of stroke were those least likely to receive anticoagulant treatment. Undertreatment was common amongst women and individuals >80years, whilst overtreatment was common amongst young men without risk factors.CONCLUSION: The prevalence of atrial fibrillation is at least 2.9% of the Swedish adult population, not counting 'silent atrial fibrillation'. The official US figures probably underestimate the magnitude of the problem by a factor of 3-5. More than 80% had risk factors motivating anticoagulation therapy.