Screening for Atrial Fibrillation in American Indian Adults in a Tribal Primary Care Clinic
| Autor: | Marty M. Lofgren, Ben Freedman, Zain Ul Abideen Asad, Stavros Stavrakis, Lancer D. Stephens, Khaled Elkholey |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Time Factors digital health 030204 cardiovascular system & hematology Electrocardiography 03 medical and health sciences 0302 clinical medicine Atrial Fibrillation Prevalence Humans Mass Screening Medicine Arrhythmia and Electrophysiology Prospective Studies 030212 general & internal medicine Opportunistic screening American Indian or Alaska Native Original Research Aged Primary Health Care business.industry screening Incidence American Indian adults Oklahoma Atrial fibrillation Racial group Middle Aged medicine.disease Digital health Primary care clinic Family medicine Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| ISSN: | 2047-9980 |
| Popis: | Background American Indian adults have a higher risk of atrial fibrillation (AF) compared with other racial groups. We implemented opportunistic screening to detect silent AF in American Indian adults attending a tribal health system using a mobile, single‐lead ECG device. Methods and Results American Indian patients aged ≥50 years followed in a tribal primary care clinic with no history of AF underwent a 30‐second ECG. A cardiologist overread all tracings to confirm the diagnosis of AF. After AF was confirmed, patients were referred to their primary care physician for initiation of anticoagulation. Patients seen over the same time period, who were not undergoing screening, served as controls. A total of 1019 patients received AF screening (mean age, 61.5±8.9 years, 62% women). Age and sex distribution of those screened was similar to the overall clinic population. New AF was diagnosed in 15 of 1019 (1.5%) patients screened versus 4 of 1267 (0.3%) patients who were not screened (mean difference, 1.2%; 95% CI, 0.3%–2.2%, P =0.002). Eight of 15 with new screen‐detected AF were aged 2 DS 2 ‐VASc score than those without AF. Fourteen of 15 patients diagnosed with new AF had a CHA 2 DS 2 ‐VASc score ≥1 and initiated anticoagulation. Conclusions Opportunistic, mobile single‐lead ECG screening for AF is feasible in tribal clinics, and detects more AF than usual care, leading to appropriate initiation of anticoagulation. AF develops at a younger age in American Indian adults who would likely benefit from earlier AF screening. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03740477. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text