Prevalence and treatment of atrial fibrillation in UK general practice from 2000 to 2016
Prevalence and treatment of atrial fibrillation in UK general practice from 2000 to 2016
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DOI：
10.1136/heartjnl-2018-312977
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发表时间：
2019-01-01
期刊：
影响因子：
5.7
通讯作者：
Marshall, Tom
中科院分区：
文献类型：
--
作者：
Adderley, Nicola Jaime;Ryan, Ronan;Marshall, Tom
目的房颤是最常见的心律失常，是脑卒中的重要危险因素。抗凝治疗可显著降低中风风险。目前英国房颤的患病率和治疗率以及近年来的变化尚不清楚。本分析的目的是确定2000年至2016年英国年龄性别特异性房颤患病率和治疗的趋势。方法在2000年至2016年期间，使用英国全科医生注册的患者电子初级保健记录大型数据库进行17次连续横断面分析。这些指标确定了诊断为房颤的患者的患病率、房颤患者的卒中风险以及目前接受抗凝治疗的房颤患者的比例。采用CHA(2)DS(2)-VASc评分评估卒中风险。结果年龄-性别标准化房颤患病率从2000年的2.14% （95% CI 2.11% ~ 2.17%）上升至2016年的3.29% （95% CI 3.27% ~ 3.32%）。2000年至2016年间，在卒中高危人群中，使用房颤处方抗凝药物的患者比例从35.4% （95% CI 34.7%至36.1%）增加到75.5% (95% CI 75.1%至75.8%)（p随时间变化）
Objective Atrial fibrillation (AF) is the most common cardiac arrhythmia and an important risk factor for stroke. Treatment with anticoagulants substantially reduces risk of stroke. Current prevalence and treatment rates of AF in the UK as well as changes in recent years are not known. The aim of this analysis was to determine trends in age-sex specific prevalence and treatment of AF in the UK from 2000 to 2016. Methods 17 sequential cross-sectional analyses were carried out between 2000 and 2016 using a large database of electronic primary care records of patients registered with UK general practitioners. These determined the prevalence of patients diagnosed with AF, the stroke risk of those with AF and the proportion of AF patients currently receiving anticoagulants. Stroke risk was assessed using CHA(2)DS(2)-VASc score. Results Age-sex standardised AF prevalence increased from 2.14% (95% CI 2.11% to 2.17%) in 2000 to 3.29% (95% CI 3.27% to 3.32%) in 2016. Between 2000 and 2016, the proportion of patients with AF prescribed anticoagulants increased from 35.4% (95% CI 34.7% to 36.1%) to 75.5% (95% CI 75.1% to 75.8%) in those with high stroke risk (p for change over time