Atrial Fibrillation Diagnosis using ECG Records and Self-Report in the Community: Cross-Sectional Analysis from ELSA-Brasil.

Autor:	Santos IS; Hospital Universitário da Universidade de São Paulo, Centro de Pesquisa Clínica e Epidemiológica, São Paulo, SP - Brasil., Lotufo PA; Hospital Universitário da Universidade de São Paulo, Centro de Pesquisa Clínica e Epidemiológica, São Paulo, SP - Brasil., Brant L; Faculdade de Medicina da Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Belo Horizonte, MG - Brasil., Pinto Filho MM; Faculdade de Medicina da Universidade Federal de Minas Gerais - Programa de Pós-Graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG - Brasil., Pereira ADC; Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - Laboratório de Genética e Cardiologia Molecular, São Paulo, SP - Brasil., Barreto SM; Universidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil., Ribeiro AL; Universidade Federal de Minas Gerais - Centro de Telessaúde - Hospital das Clínicas - UFMG, Belo Horizonte, MG - Brasil., Thomas GN; University of Birmingham College of Medical and Dental Sciences - Institute of Applied Health Research, Birmingham - Reino Unido da Grã-Bretanha., Lip GYH; University of Liverpool - Liverpool Centre for Cardiovascular Science, Liverpool, Merseyside - Reino Unido da Grã-Bretanha.; Liverpool Heart & Chest Hospital, Liverpool - Reino Unido da Grã-Bretanha.; Aalborg Universitet - Aalborg Thrombosis Research Unit, Aalborg - Dinamarca., Bensenor IM; Hospital Universitário da Universidade de São Paulo, Centro de Pesquisa Clínica e Epidemiológica, São Paulo, SP - Brasil.
Jazyk:	English; Portuguese
Zdroj:	Arquivos brasileiros de cardiologia [Arq Bras Cardiol] 2021 Sep; Vol. 117 (3), pp. 426-434.
DOI:	10.36660/abc.20190873
Abstrakt:	Background: Atrial fibrillation or flutter (AFF) is the most common sustained cardiac arrhythmia. Limited data can be found on AFF epidemiology in South America. Objective: The present study sought to describe the clinical epidemiology of AFF and the use of stroke prevention medication in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline assessment. Methods: This study analyzed data from 13,260 ELSA-Brasil participants. AFF was defined according to ECG recording or by self-report. Logistic regression models were built to analyze factors associated with AFF. This study also analyzed if age and sex were associated with anticoagulant use for stroke prevention. Significance level was set at 5%. Results: Median age was 51 years and 7,213 (54.4%) participants were women. AFF was present in 333 (2.5%) participants. Increasing age (odds ratio [OR]:1.05; 95% confidence interval [95%CI]: 1.04-1.07), hypertension (OR:1.44; 95%CI: 1.14-1.81), coronary heart disease (OR: 5.11; 95%CI: 3.85-6.79), heart failure (OR:7.37; 95%CI: 5.00-10.87), and rheumatic fever (OR:3.38; 95%CI: 2.28-5.02) were associated with AFF. From 185 participants with AFF and a CHA2DS2-VASc score ≥2, only 20 (10.8%) used anticoagulants (50.0% among those with AFF in the baseline ECG). Stroke prevention in this group was associated with a higher age (1.8% vs 17.7% in those aged ≤ 54 and ≥ 65 years, respectively; p=0.013). A trend towards a reduced anticoagulant use was observed in women (7.1% vs. 16.4% in women and men, respectively; p=0.055). Conclusions: At the ELSA-Brasil baseline, 2.5% of the participants had AFF. The lack of stroke prevention was common, which is an especially challenging point for healthcare in this setting.
Databáze:	MEDLINE
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