Oral anticoagulant therapy for patients with atrial fibrillation - an update

摘要

It is projected that 7.5 million individuals will have atrial fibrillation (AF) in the United States by the year 2020 . The reason for this increasing prevalence is multifactorial and due in part to the increased prevalence of risk factors for AF like hypertension, heart failure, diabetes, obesity, and older age. Among individuals age 80 years and greater, the prevalence of AF is approximately 10 percent . Atrial fibrillation confers a five-fold increased risk of stroke and 15 percent of all strokes occur in people with AF. The attributable risk of stroke with AF differs by age, 1.5 percent for those 50 to 59 years versus 23.5 percent for those 80 to 89 years. Untreated, the average rate of stroke per year is 5 percent . The global impact of stroke is enormous. It is the third most common cause of death in developed countries and the leading cause of serious long term disability. The disability adjusted life years are projected to reach 61 million years per 1,000 population by the year 2020 which is significantly increased from 38 million in 1990 . The 30-day mortality of AF-related stroke has been shown in multiple studies to approximate 23-25 percent