January 1, 2013Open Access
The Prevalence, Impact and Economic Implications of Atrial Fibrillation in Stroke: What Progress Has Been Made?
Key Result
The age-adjusted prevalence of atrial fibrillation and the relative risk of stroke associated with atrial fibrillation have remained relatively constant over the last 30 years.
Study Design
Type
Systematic Review
Structured PICO
How have the prevalence of AF, the risk of AF-related stroke, and associated economic costs changed over the last 30 years?
P
Population
Populations assessed for atrial fibrillation prevalence, AF-related stroke risk, and economic costs over the last 30 years
O
Outcome
Changes in the prevalence of AF, the risk of stroke associated with AF, and the excess cost of AF-related stroke
The age-adjusted prevalence of AF and its associated relative risk of stroke have remained constant over the last 30 years, highlighting a growing public health and economic burden.
Abstract
Atrial fibrillation (AF) is a major risk factor for stroke, especially in the elderly. Increased life expectancies mean that AF-related stroke is a growing global public health concern. Improvements in the detection, treatment and prevention of the consequences of AF have occurred in recent years. However, the extent to which these improvements have impacted on the prevalence of AF, the risk of AF-related stroke and subsequent economic costs are unknown. This review provides a contemporary assessment of the epidemiological data on AF-related stroke aimed at assessing the effectiveness of primary prevention strategies and associated economic implications with reductions in stroke incidence. A systematic review of the literature was performed. Appropriately designed studies were identified and retrieved. Evidence on changes in the prevalence of AF, the risk of stroke associated with AF and the excess cost of AF-related stroke over the last 30 years was summarised. The results provide evidence that the age-adjusted prevalence of AF and the relative risk of stroke associated with AF has remained relatively constant. Unless action is taken to improve detection of AF and reduce its consequences, a considerable increase in the social and economic burden associated with AF-related stroke is likely.