Carta Revisado por pares

Atrial Fibrillation: The Epidemic of the New Millennium

1999; American College of Physicians; Volume: 131; Issue: 7 Linguagem: Inglês

10.7326/0003-4819-131-7-199910050-00011

ISSN

1539-3704

Autores

Michael D. Ezekowitz,

Tópico(s)

Acute Ischemic Stroke Management

Resumo

Editorials5 October 1999Atrial Fibrillation: The Epidemic of the New MillenniumMichael D. Ezekowitz, MD, PhDMichael D. Ezekowitz, MD, PhDYale University School of Medicine; New Haven, CT 06510 (Ezekowitz)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-7-199910050-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail By the year 2030, the number of Americans older than 65 years of age will double. Approximately 4% of persons 65 years of age will have atrial fibrillation, and this percentage will increase to approximately 15% at age 75 (1, 2). These data have important implications for the health care system. Most of this growing population of patients will need a simple, cost-effective treatment strategy that can be managed in a primary care setting.In this issue, Hart and colleagues (3) review stroke prevention trials in patients with atrial fibrillation and confirm the well-described, consistent benefit of warfarin over both ...References1. Hobbs F, Damon BL, Taeuber CM. Sixty-five plus in the United States. Current Population Reports, Special Studies, no. P23-190. Washington, DC: U.S. Dept. of Commerce, Economics, and Statistics Administration, Bureau of the Census; 1996. Google Scholar2. Kannel WB, Abbott RD, Savage DD, McNamara PM. Epidemiologic features of chronic atrial fibrillation: the Framingham study. N Engl J Med. 1982;306:1018-22. CrossrefMedlineGoogle Scholar3. Hart RG, Benavente O, McBride R, Pearce LA. Antithrombotic therapy to prevent stroke in patients with atrial fibrillation: a meta-analysis. Ann Intern Med. 1999;131:492-501. LinkGoogle Scholar4. Ezekowitz MD, Levine JA. Preventing stroke in patients with atrial fibrillation. JAMA. 1999;281:1830-5. CrossrefMedlineGoogle Scholar5. Antani MR, Beyth RJ, Covinsky KE, Anderson PA, Miller DG, Cebul RD, et al . Failure to prescribe warfarin to patients with nonrheumatic atrial fibrillation. J Gen Intern Med. 1996;11:713-20. CrossrefMedlineGoogle Scholar6. Laupacis A, Albers G, Dalen J, Dunn MI, Jacobson AK, Singer DE. Antithrombotic therapy in atrial fibrillation. Chest. 1998;114 5 Suppl 579S-589S. CrossrefMedlineGoogle Scholar7. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. JAMA. 1991; 265:3255-64. Google Scholar8. Massicotte P, Marzinotto V, Vegh P, Adams M, Andrew M. Home monitoring of warfarin therapy in children with a whole blood prothrombin time monitor. J Pediatr. 1995;127:389-94. CrossrefMedlineGoogle Scholar9. Kilander L, Andren B, Nyman H, Lind L, Boberg M, Lithell H. Atrial fibrillation is an independent determinant of low cognitive function: a cross-sectional study in elderly men. Stroke. 1998;29:1816-20. CrossrefMedlineGoogle Scholar10. Patients with nonvalvular atrial fibrillation at low risk of stroke during treatment with aspirin: Stroke Prevention in Atrial Fibrillation III Study. The SPAF III Writing Committee for the Stroke Prevention in Atrial Fibrillation Investigators. JAMA. 1998; 279:1273-7. Google Scholar11. Ezekowitz MD, James KE, Nazarian SM, Davenport J, Broderick JP, Gupta SR, et al . Silent cerebral infarction in patients with nonrheumatic atrial fibrillation. The Veterans Affairs Stroke Prevention in Nonrheumatic Atrial Fibrillation Investigators. Circulation. 1995;92:2178-82. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Michael D. Ezekowitz, MD, PhDAffiliations: Yale University School of Medicine; New Haven, CT 06510 (Ezekowitz)Note: Dr. Ezekowitz is a consultant for several companies, including DuPont, the manufacturer of Coumadin.Acknowledgment: The author thanks Paulette Trent for administrative support.Corresponding Author: Michael D. Ezekowitz, MD, PhD, Yale Clinical Trials Office, Yale University School of Medicine, 47 College Street, Suite 202, New Haven, CT 06510. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAntithrombotic Therapy To Prevent Stroke in Patients with Atrial Fibrillation Robert G. Hart , Oscar Benavente , Ruth McBride , and Lesly A. Pearce Metrics Cited byTO DETERMINE THE ROLE OF RANOLAZINE FOR RHYTHM CONTROL STRATEGY IN PATIENTS WITH NON- VALVULAR ATRIAL FIBRILLATION- AN OBSERVATIONAL STUDY FROM A TERTIARY CARE CENTER. (RANOVA STUDY)Anticoagulant therapy in elderly patients and cardiac implantable electronic devicesInternational longitudinal registry of patients with atrial fibrillation and treated with rivaroxaban: RIVaroxaban Evaluation in Real life setting (RIVER)Increasing population height and risk of incident atrial fibrillation: the Copenhagen City Heart StudyReal-practice thromboprophylaxis in atrial fibrillationThromboprophylaxis in Patients with Atrial Fibrillation: A Real Practice Analysis«Estudo LEGACY: Efeitos a longo prazo do controlo de peso guiado por objetivos numa coorte com fibrilhação auricular»«Estudo LEGACY: Efeitos a longo prazo do controlo de peso guiado por objetivos numa coorte com fibrilhação auricular»Untreated atrial fibrillation in the United Kingdom: Understanding the barriers and treatment optionsComparison of the Frequency of Atrial Fibrillation in Young Obese Versus Young Nonobese Men Undergoing Examination for Fitness for Military ServiceAdult height and risk of ischemic heart disease, atrial fibrillation, stroke, venous thromboembolism, and premature death: a population based 36-year follow-up studyHospitalized patients with atrial fibrillation compared to those included in recent trials on novel oral anticoagulants: A population-based studyOverview of pathophysiology and management of AFNot everything about atrial fibrillation is a hot topic: drug-induced atrial fibrillation is an exceptionA role for pharmacists in community-based post-discharge warfarin management: protocol for the 'the role of community pharmacy in post hospital management of patients initiated on warfarin' studyImpact of Obesity on Cardiovascular DiseaseSafety and Efficacy of Transjugular Renal Biopsy Performed by Interventional NephrologistsREVIEW: New Antithrombotics for Atrial FibrillationAtrial fibrillation in incident dialysis patientsImpact of Obesity on Cardiovascular DiseaseOmega-3 fatty acid supplementation reduces one-year risk of atrial fibrillation in patients hospitalized with myocardial infarction'Pressure-flow'-triggered intracellular Ca 2+ transients in rat cardiac myocytes: possible mechanisms and role of mitochondriaIncidencia de la fibrilación auricular en los pacientes en hemodiálisis. 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A Prospective Long-Term Follow-Up StudyNew Antiarrhythmic Drugs for Prevention of Atrial FibrillationAntithrombotic Therapy for Stroke Prevention in Atrial FibrillationAnalysis of the Frequency of Cardiac Arrhythmias and Conduction Disturbances From a Health-Care PerspectiveAnálisis de la frecuencia de las arritmias cardíacas y de los trastornos de conducción desde una perspectiva asistencialAnticoagulants for stroke prevention in atrial fibrillation: what is the right rate and where do we go from here?Indication for antithrombotic therapy for atrial fibrillation: reconciling the guidelines with clinical practiceThe Epidemiology of Atrial Fibrillation in Elderly Persons: The Tip of the IcebergVorhofflimmern und Thromboembolieprophylaxe bei �lteren PatientenPatrones clínicos de presentación de la fibrilación auricular en los pacientes hospitalizadosManaging Anticoagulation in Patients with Atrial FibrillationAtrial Fibrillation in the 21st Century: The New Cardiac 'Cinderella' and New Horizons for Cardiovascular Nursing?The role of inositol 1,4,5‐trisphosphate receptors in Ca 2+ signalling and the generation of arrhythmias in rat atrial myocytesAtrial DefibrillatorsOutcomes in the management of atrial fibrillation: clinical trial results can apply in practiceEpidemiology and natural history of atrial fibrillation: clinical implicationsAntithrombotic therapy in atrial fibrillationFactores de riesgo de un nuevo accidente cerebral cardioembólico en la fibrilación auricular no valvular tratada con acenocumarolCost Effectiveness of Therapies for Atrial FibrillationRenal biopsy in high-risk patients with medical diseases of the kidney 5 October 1999Volume 131, Issue 7Page: 537-538KeywordsAtrial fibrillationElderlyFearHemorrhageHypertensionInternational normalized ratioIschemic strokeMedical risk factorsPathogenesisStroke ePublished: 15 August 2000 Issue Published: 5 October 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. 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