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July 29, 2021Thrombosis and HaemostasisOpen Access

Screening for Atrial Fibrillation in Relation to Stroke and Mortality Risk

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Key result

Asymptomatic incidentally detected AF carries similar stroke risk to symptomatic presentations.

  • n=45,640

Why the study?

There is a lack of solid data regarding the reduction of adverse clinical outcomes in subjects undergoing screening for asymptomatic atrial fibrillation compared with other detection modes.

Does the mode of atrial fibrillation detection (asymptomatic vs symptomatic/hospitalized) affect the risk of stroke and mortality?

Population

22,035 adult (18–84 years) subjects with incident AF and 23,605 non-AF matched patients

Comparison

Mode of AF detection: asymptomatic incidentally detected vs symptomatic ambulatory vs primary hospital discharge vs nonprimary hospital discharge

Design

Observational analysis from UK Clinical Practice Research Datalink linked to hospital and mortality data

Follow-up

3 years

Authors

MPMarco ProiettiGBGiuseppe Boriani

Discussion

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Member takes

Overview

May support AF screening; extends observational associations but leaves open randomized outcome data.

Structured PICO

Does the mode of atrial fibrillation detection (asymptomatic vs symptomatic/hospitalized) affect the risk of stroke and mortality?

P
Population
22,035 adults aged 18-84 with incident atrial fibrillation categorized by detection mode and 23,605 matched non-AF controls, followed for 3 years.
E
Exposure
Mode of atrial fibrillation detection (asymptomatic incidentally detected, symptomatic ambulatory, primary hospital discharge, nonprimary hospital discharge).
C
Comparator
Asymptomatic incidentally detected ambulatory AF (AA-AF) and non-AF matched patients.
O
Outcome
Occurrence of stroke and all-cause death.hard clinical

Asymptomatic incidentally detected atrial fibrillation carries a similar risk of ischemic stroke as symptomatic presentations, highlighting the potential clinical importance of AF screening strategies.

Limitations

  • Lack of solid data regarding the reduction of adverse clinical outcomes in subjects undergoing screening
  • Need for more data on the effects of screening on patient anxiety

Cite This Study

Proietti et al. (2021) conducted an editorial in Atrial fibrillation (n=45,640). Asymptomatic incidentally detected ambulatory atrial fibrillation vs. Symptomatic ambulatory AF, hospital-diagnosed AF, and non-AF was evaluated on Stroke. Asymptomatic incidentally detected atrial fibrillation (24.5% of incident cases) was associated with a similar risk of stroke compared to symptomatic presentations over a 3-year follow-up.

synapsesocial.com/papers/6aae44d26775d5a42c76f376https://doi.org/10.1055/a-1562-0747
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