Incidence, prevalence, and antithrombotic management of atrial fibrillation in elderly Germans

Data on the epidemiology of atrial fibrillation (AF) and its antithrombotic management in elderly populations are scarce. The aims of this study were to estimate the incidence and prevalence of AF in the elderly in Germany and to describe antithrombotic management of AF cases.

Estimation of prevalence and incidence was based on data of three German statutory health insurances, which insured more than 800 000 people aged 65 years and older in the study period. The 1-year period prevalence of AF was estimated for each of the years 2004-2007. The incidence rate of AF in 2007 was assessed in patients with a preceding continuous 3-year insurance period without diagnoses of AF. Antithrombotic management of AF was described among incident AF cases in 2008 and predictors for lack of prescriptions of oral anticoagulants were identified. Age-standardized period prevalence of AF among those 65 years or older was 7.7% in 2004, 9.4% in 2005, 9.8% in 2006, and 10.3% in 2007. The age-standardized incidence of AF was 27.4 of 1000 person-years in 2007. Prevalence and incidence increased with age and were higher in men than in women. In 2008, 58.2% of new AF cases received antithrombotic drugs. Treatment was less common among women and older people.

Incidence and prevalence of AF are relatively high in the elderly in Germany. A considerable fraction of new AF cases did not receive antithrombotic drugs in routine care.