RESUMEN - Vol. 28 - Nº 1 - Abril 2013
Prevalence of atrial fibrillation in the generalpopulation and in high-risk groups: the ECHOES study
Russell C. Davis1, F.D. Richard Hobbs2, Joyce E. Kenkre3, Andrea K. Roalfe2,
Rachel Iles2, Gregory Y.H. Lip1, y Michael K. Davies4
Este artículo fue publicado en Europace 2012; 14: 1553–9, y es reproducido y traducido con autorización.
1. University Department of Medicine, Sandwell & West Birmingham Hospitals NHS Trust, West Bromwich,West Midlands, UK.
2. Department of Primary Care and General Practice, University of Birmingham, Birmingham, West Midlands, UK.
3. Health, Sport and Science, University of Glamorgan, Mid Glamorgan, Wales, UK.
4. Department of Cardiology, University Hospital Birmingham NHS Trust, Birmingham, West Midlands, UK.
Conflicto de intereses: Ninguno declarado.
Financiamiento: este trabajo fue apoyado por el Programa de Evaluación de Investigación y Desarrollo de Tecnologías del Servicio Nacional de Salud del Reino Unido.
Aspectos éticos: el estudio se atuvo a la Declaración de Helsinki; el protocolo de investigación fue aprobado por el comité local de ética en la investigación de cada dependencia de salud incluido en el estudio, y todos los sujetos dieron su consentimiento informado.
Recibido el 1º de enero de 2012, aceptado tras su revisión el 14 de marzo de 2012; publicación electrónica previa a la impresa el 5 de abril de 2012
Summary
Aim: To establish the prevalence of atrial fibrillation (AF) in the general population in the UK, and in those with risk factors.
Methods and results: The prevalence of AF on electrocardiography was established in prospectively selected groups: 3960 randomly selected from the population, aged 45+; 782 with a previous diagnosis of heart failure; and 1062 with a record of myocardial infarction, hypertension, angina, or diabetes. Patients were also assessed clinically and with echocardiography. Mortality was tracked for 8 years. Atrial fibrillation was found in 78 of the random population sample (2.0%). Prevalence was 1.6% in women and 2.4% in men, rising with age from 0.2% in those aged 45-54 to 8.0% in those aged 75 and older. Half of all cases were in patients aged 75 and older. Only 23 of the 78 (29.5%) of those in AF took warfarin. Of the 782 patients, 175 (22.4%) with a diagnosis of heart failure were in AF, with normal left ventricular function in 95 (54.3%) of these. Atrial fibrillation was found in 14 of the 244 (5.7%) of those with a history of myocardial infarction, 15 of the 388 (3.9%) of those with hypertension, 15 of the 321 (4.7%) of those with angina, and 11 of the 208 (5.3%) of diabetics. Adjusting for age and sex, mortality was 1.57 times higher for those in AF.
Conclusion: Atrial fibrillation is common in the elderly and those with clinical risk factors. Screening these groups would identify many with AF. Use of anticoagulation was low at the time of the initial assessments in the late 1990s; practice may have changed recently.
Correspondencia:Russell Davis, Sandwell & West Birmingham Hospitals NHS Trust, Sandwell General Hospital, Lyndon, West Bromwich. Correo electrónico: russell.davis@swbh.nhs.uk