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Related Experiment Videos

Comorbidity associated with atrial fibrillation: a general practice-based study.

K Carroll1, A Majeed

  • 1Office for National Statistics, London. Carrollkev@aol.com

The British Journal of General Practice : the Journal of the Royal College of General Practitioners
|January 5, 2002
PubMed
Summary
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Atrial fibrillation significantly increases stroke risk factors, yet contraindications for anticoagulation are common. Approximately 40% of atrial fibrillation patients in primary care have stroke risk factors and no treatment contraindications.

Area of Science:

  • Cardiology
  • Epidemiology
  • Public Health

Background:

  • Atrial fibrillation (AF) is a major risk factor for ischemic stroke.
  • Anticoagulation (e.g., warfarin) reduces stroke risk in AF patients but has side effects.
  • Limited population-based data exists on comorbidities and contraindications for anticoagulation in AF patients.

Purpose of the Study:

  • To determine the prevalence of ischemic stroke risk factors in AF patients.
  • To identify the prevalence of potential contraindications to anticoagulant therapy in AF patients.

Main Methods:

  • A one-year prospective cohort study involving 60 general practices in England and Wales.
  • Analysis of a population of 502,493 individuals.
  • Calculation of age and sex-specific prevalence rates and relative risks for stroke risk factors and contraindications.

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Main Results:

  • 1,414 patients (0.3%) had atrial fibrillation.
  • Stroke risk factors increased with age in both men and women with AF.
  • Contraindications to antithrombotic treatment were present in 5-14% of men and 7-16% of women with AF, increasing with age.
  • 40% of AF patients had at least one stroke risk factor and no contraindications to antithrombotic treatment.

Conclusions:

  • Atrial fibrillation is linked to a higher prevalence of stroke risk factors.
  • Contraindications to antithrombotic treatment are similarly distributed in patients with and without AF.
  • A significant proportion (around 40%) of primary care AF patients are at high stroke risk without contraindications for treatment.