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Global variations in the prevalence, treatment, and impact of atrial fibrillation in a multi-national cohort of 153 152 middle-aged individuals

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dc.contributor.authorJoseph, Philip
dc.contributor.authorHealey, Jeffrey S.
dc.contributor.authorRaina, Parminder
dc.contributor.authorConnolly, Stuart J.
dc.contributor.authorIbrahim, Quazi
dc.contributor.authorGupta, Rajeev
dc.contributor.authorAvezum, Alvaro
dc.contributor.authorDans, Antonio
dc.contributor.authorLopez-Jaramillo, Patricio
dc.contributor.authorYeates, Karen
dc.contributor.authorTeo, Koon
dc.contributor.authorDouma, Reuben
dc.contributor.authorBahonar, Ahmad
dc.contributor.authorChifamba, Jephat
dc.contributor.authorLanas, Fernando
dc.contributor.authorDagenais, Gilles R.
dc.contributor.authorLear, Scott
dc.contributor.authorKumar, Rajesh
dc.contributor.authorKengne, Andre P.
dc.contributor.authorKeskinler, Mirac
dc.contributor.authorMohan, Viswanathan
dc.contributor.authorMony, Prem
dc.contributor.authorAlhabib, Khalid F.
dc.contributor.authorHuisman, Hugo
dc.contributor.authorIype, Thomas
dc.contributor.authorZatonska, Katarzyna
dc.contributor.authorIsmail, Rosnah
dc.contributor.authorKazmi, Khawar
dc.contributor.authorRosengren, Annika
dc.contributor.authorRahman, Omar
dc.contributor.authorYusufali, Afzalhussein
dc.contributor.authorWei, Li
dc.contributor.authorOrlandini, Andres
dc.contributor.authorIslam, Shofiqul
dc.contributor.authorRangarajan, Sumathy
dc.contributor.authorYusuf, Salim
dc.contributor.authorThe PURE Investigators
dc.contributor.researchgroupMasiraspa
dc.date.accessioned2022-02-23T22:42:50Z
dc.date.available2022-02-23T22:42:50Z
dc.date.issued2021-06-05
dc.descriptionDigitalspa
dc.description.abstractAims To compare the prevalence of electrocardiogram (ECG)-documented atrial fibrillation (or flutter) (AF) across eight regions of the world, and to examine antithrombotic use and clinical outcomes. Methods and results Baseline ECGs were collected in 153 152 middle-aged participants (ages 35–70 years) to document AF in two community-based studies, spanning 20 countries. Medication use and clinical outcome data (mean follow-up of 7.4 years) were available in one cohort. Cross-sectional analyses were performed to document the prevalence of AF and medication use, and associations between AF and clinical events were examined prospectively. Mean age of participants was 52.1 years, and 57.7% were female. Age and sex-standardized prevalence of AF varied 12-fold between regions; with the highest in North America, Europe, China, and Southeast Asia (270–360 cases per 100 000 persons); and lowest in the Middle East, Africa, and South Asia (30–60 cases per 100 000 persons) (P < 0.001). Compared with low-income countries (LICs), AF prevalence was 7-fold higher in middle-income countries (MICs) and 11-fold higher in high-income countries (HICs) (P < 0.001). Differences in AF prevalence remained significant after adjusting for traditional AF risk factors. In LICs/MICs, 24% of participants with AF and a CHADS2 score ≥1 received antithrombotic therapy, compared with 85% in HICs. AF was associated with an increased risk of stroke [hazard ratio (HR) 2.29; 95% confidence interval (CI) 1.49–3.52] and death (HR 2.97; 95% CI 2.25–3.93); with similar rates in different countries grouped by income level. Conclusions Large variations in AF prevalence occur in different regions and countries grouped by income level, but this is only partially explained by traditional AF risk factors. Antithrombotic therapy is infrequently used in poorer countries despite the high risk of stroke associated with AF.spa
dc.description.researchareaCiencias Médicas y de la Saludspa
dc.format.extent9 pspa
dc.format.mimetypeapplication/pdfspa
dc.identifier.doihttps://doi.org/10.1093/cvr/cvaa241
dc.identifier.urihttps://repositorio.udes.edu.co/handle/001/6140
dc.language.isoengspa
dc.publisherOxford Academicspa
dc.publisher.placeReino Unidospa
dc.relation.citationendpage1531spa
dc.relation.citationissue6spa
dc.relation.citationstartpage1523spa
dc.relation.citationvolume117spa
dc.relation.citesPhilip G Joseph, Jeffrey S Healey, Parminder Raina, Stuart J Connolly, Quazi Ibrahim, Rajeev Gupta, Alvaro Avezum, Antonio L Dans, Patricio Lopez-Jaramillo, Karen Yeates, Koon Teo, Reuben Douma, Ahmad Bahonar, Jephat Chifamba, Fernando Lanas, Gilles R Dagenais, Scott A Lear, Rajesh Kumar, Andre P Kengne, Mirac Keskinler, Viswanathan Mohan, Prem Mony, Khalid F Alhabib, Hugo Huisman, Thomas Iype, Katarzyna Zatonska, Rosnah Ismail, Khawar Kazmi, Annika Rosengren, Omar Rahman, Afzalhussein Yusufali, Li Wei, Andres Orlandini, Shofiqul Islam, Sumathy Rangarajan, Salim Yusuf, the PURE Investigators, Global variations in the prevalence, treatment, and impact of atrial fibrillation in a multi-national cohort of 153 152 middle-aged individuals, Cardiovascular Research, Volume 117, Issue 6, 1 June 2021, Pages 1523–1531, https://doi.org/10.1093/cvr/cvaa241
dc.relation.indexedScopusspa
dc.relation.ispartofjournalCardiovascular Researchspa
dc.rightsCopyright © 2022 The Authors, European Society of Cardiologyspa
dc.rights.accessrightsinfo:eu-repo/semantics/closedAccessspa
dc.rights.creativecommonsAtribución-NoComercial 4.0 Internacional (CC BY-NC 4.0)spa
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/spa
dc.sourcehttps://academic.oup.com/cardiovascres/article-abstract/117/6/1523/5890677?redirectedFrom=fulltextspa
dc.titleGlobal variations in the prevalence, treatment, and impact of atrial fibrillation in a multi-national cohort of 153 152 middle-aged individualsspa
dc.typeArtículo de revistaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_6501spa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/articlespa
dc.type.redcolhttp://purl.org/redcol/resource_type/ARTspa
dc.type.versioninfo:eu-repo/semantics/publishedVersionspa
dcterms.audienceTodas las Audienciasspa
dspace.entity.typePublication
oaire.accessrightshttp://purl.org/coar/access_right/c_14cbspa
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85spa
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