Dataset Information

Age and Sex Specific Prevalence of Clinical and Screen-Detected Atrial Fibrillation in Hospitalized Patients.

ABSTRACT:

Background

The prevalence of atrial fibrillation (AF) is high in older patients. The present study aimed to estimate the age and sex specific prevalence of clinical and screen-detected atrial fibrillation (AF) in hospitalized patients.

Methods

The STAR-FIB cohort study was a prospective cohort study recruiting participants from a large source population of hospitalized patients aged 65-84 years. The estimated size of the source population was 26,035 (95% CI 25,918-26,152), and 795 consenting patients without clinical AF were included in the cohort study after stratification by sex and age (49.2% females; mean age 74.7 years). Patients in the cohort study underwent three seven-day Holter ECGs in intervals of two months to screen for AF.

Results

In the source population, the estimated prevalence of clinical AF was 22.2% (95% CI 18.4-26.1), 23.8% for males (95% CI 20.9-26.6) and 19.8% for females (95% CI 17.3-22.4; p for difference between sexes, 0.004). There was a linear trend for an increase in the prevalence of clinical AF with increasing age, overall and in both sexes. In the cohort study, AF was newly diagnosed in 38 patients, for an estimated prevalence of screen-detected AF of 4.9% overall (95% CI 3.3-6.6), 5.5% in males (95% CI 3.2-7.8) and 4.0% in females (95% CI 2.0-6.0; p for difference between sexes, 0.041). The estimated prevalence of screen-detected AF in the source population was 3.8% overall, 4.2% in males and 3.2% in females.

Conclusion

In a large hospital-based patient population aged 65-84 years, the prevalence of clinical AF and of screen-detected AF was 22.2% and 3.8%, respectively, and significantly higher in males than females.

SUBMITTER: Roten L

PROVIDER: S-EPMC8584962 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundAfrican Americans are consistently found to have a lower prevalence of clinically detected atrial fibrillation (AF) than whites, despite a higher prevalence of major AF risk factors and higher risk of ischemic stroke. Long-term ambulatory ECG monitors provide the opportunity for unbiased AF detection. We determined differences by race/ethnicity in the prevalence of clinically detected AF and in the proportion with monitor-detected AF.MethodsWe conducted a cross-sectional analysis in the MESA (Multi-Ethnic Study of Atherosclerosis), a community-based cohort study that enrolled 6814 Americans free of clinically recognized cardiovascular disease in 2000 to 2002. At the 2016 to 2018 examination, 1556 individuals participated in an ancillary study involving ambulatory ECG monitoring and had follow-up for clinically detected AF since cohort entry.ResultsAmong 1556 participants, 41% were white, 25% African American, 21% Hispanic, and 14% Chinese; 51% were women; and the mean age was 74 years. The prevalence of clinically detected AF after 14.4 years' follow-up was 11.3% in whites, 6.6% in African Americans, 7.8% in Hispanics, and 9.9% in Chinese and was significantly lower in African Americans than in whites, in both unadjusted and risk factor-adjusted analyses (adjusted rate difference, -6.6% [95% CI, -10.1% to -3.1%]; P<0.001). By contrast, in the same individuals, the proportion with monitor-detected AF using a 14-day ambulatory ECG monitor was similar in the 4 race/ethnic groups: 7.1%, 6.4%, 6.9%, and 5.2%, respectively (compared with whites, all P>0.5).ConclusionsThe prevalence of clinically detected AF was substantially lower in African American than in white participants, without or with adjustment for AF risk factors. However, unbiased AF detection by ambulatory monitoring in the same individuals revealed little difference in the proportion with AF by race/ethnicity. These findings provide support for the hypothesis of differential detection by race/ethnicity in the clinical recognition of AF, which may have important implications for stroke prevention.