Afib: prevalence and treatment in UK general practice

Takeaway:

• Prevalence of Afib in the United Kingdom has increased across all age groups and both sexes between 2000 and 2016.
• Use of anticoagulants in eligible patients with Afib has doubled, alongside a reduction in anticoagulants use in ineligible patients with Afib.

Why this matters

• Afib is associated with increased risk for stroke, and prophylaxis with anticoagulants lowers stroke risk by two-thirds.
• There is no clarity on the current prevalence of Afib and Afib treatment rates in the United Kingdom.

Study design

• 17 cross-sectional analyses performed between 2000 and 2016 using patients’ primary care records from UK general practice databases.
• Prevalence of Afib, stroke risk associated with Afib and proportion of patients who received anticoagulants were determined.
• Funding: None disclosed.

Key results

• Crude prevalence of age–sex standardised Afib increased from 2.02% to 3.29% between 2000 and 2016.
• The proportion of prescribed anticoagulants increased in high stroke risk patients with Afib (from 35.4% to 75.5%) and moderate stroke risk patients (32.8% to 47.1%) but decreased in those with low stroke risk (19.9% to 9.7%; P<.001 for all).
• Between 2000 and 2016, the proportion of eligible patients with Afib who were prescribed anticoagulants increased in the highest-performing (from 48.0% to 82.9%) vs lowest-performing (23.5% to 62.0%) practice quintiles.

Limitation

• Omission of some hospitalised patients receiving anticoagulants.
• Over-the-counter aspirin consumption not recorded.