Milena S Marcolino1, Daniel M F Palhares2, Emelia J Benjamin3, Antonio L Ribeiro2. 1. Department of Internal Medicine, Medical School and University Hospital, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190 Room 246, CEP 30130-100 Belo Horizonte, Brazil Telehealth Network of Minas Gerais, Belo Horizonte, Brazil milenamarc@gmail.com. 2. Department of Internal Medicine, Medical School and University Hospital, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190 Room 246, CEP 30130-100 Belo Horizonte, Brazil Telehealth Network of Minas Gerais, Belo Horizonte, Brazil. 3. Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
Abstract
AIMS: Although an increasing prevalence of atrial fibrillation (AF) has been reported worldwide, there are few studies from low- and middle-income countries. Our objective is to assess the prevalence of AF and the associated medical conditions in Brazilian primary care patients. METHODS AND RESULTS: This is an observational retrospective study. Patients ≥5 years of age from primary care centres of 658 municipalities in Minas Gerais, Brazil, who performed digital electrocardiograms (ECGs) by a public telehealth service in 2011 were assessed. Clinical data were self-reported, and ECGs were interpreted by a team of trained cardiologists using standardized criteria. To assess the relation between clinical characteristics and AF, odds ratios were estimated by logistic regression. A total of 262 685 primary care patients were included, mean (SD) age of 50.3 (19.3) years, 59.6% female. Hypertension was reported in 32.0%, family history of coronary heart disease in 15.0%, diabetes in 5.4%, hyperlipidaemia in 2.8%, Chagas disease in 2.9%, and 7.1% reported current smoking. The prevalence of AF was 1.8% overall: 2.4% in men (ranging from 0.001% from 5-19 years old to 14.6% in nonagenarians) and 1.3% in women (ranging from 0.001% from 5-19 years old to 8.7% in nonagenarians) (P < 0.001). The prevalence of AF increased with advancing age. The comorbidities associated with AF were Chagas disease, previous myocardial infarction, hypertension, and chronic obstructive pulmonary disease. Vitamin K antagonist use was reported by 1.5% of patients. CONCLUSION: The prevalence and age distribution of AF were similar to studies in high-income countries. The proportion of patients who reported the use of anticoagulants was alarmingly low. Our findings point out the necessity to formulate effective treatment strategies for AF in Brazilian primary care settings. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Although an increasing prevalence of atrial fibrillation (AF) has been reported worldwide, there are few studies from low- and middle-income countries. Our objective is to assess the prevalence of AF and the associated medical conditions in Brazilian primary care patients. METHODS AND RESULTS: This is an observational retrospective study. Patients ≥5 years of age from primary care centres of 658 municipalities in Minas Gerais, Brazil, who performed digital electrocardiograms (ECGs) by a public telehealth service in 2011 were assessed. Clinical data were self-reported, and ECGs were interpreted by a team of trained cardiologists using standardized criteria. To assess the relation between clinical characteristics and AF, odds ratios were estimated by logistic regression. A total of 262 685 primary care patients were included, mean (SD) age of 50.3 (19.3) years, 59.6% female. Hypertension was reported in 32.0%, family history of coronary heart disease in 15.0%, diabetes in 5.4%, hyperlipidaemia in 2.8%, Chagas disease in 2.9%, and 7.1% reported current smoking. The prevalence of AF was 1.8% overall: 2.4% in men (ranging from 0.001% from 5-19 years old to 14.6% in nonagenarians) and 1.3% in women (ranging from 0.001% from 5-19 years old to 8.7% in nonagenarians) (P < 0.001). The prevalence of AF increased with advancing age. The comorbidities associated with AF were Chagas disease, previous myocardial infarction, hypertension, and chronic obstructive pulmonary disease. Vitamin K antagonist use was reported by 1.5% of patients. CONCLUSION: The prevalence and age distribution of AF were similar to studies in high-income countries. The proportion of patients who reported the use of anticoagulants was alarmingly low. Our findings point out the necessity to formulate effective treatment strategies for AF in Brazilian primary care settings. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Liz A Kawabata-Yoshihara; Isabela M Benseñor; Vitor S Kawabata; Paulo R Menezes; Marcia Scazufca; Paulo A Lotufo Journal: Arq Bras Cardiol Date: 2009-12 Impact factor: 2.000
Authors: Sumeet S Chugh; Rasmus Havmoeller; Kumar Narayanan; David Singh; Michiel Rienstra; Emelia J Benjamin; Richard F Gillum; Young-Hoon Kim; John H McAnulty; Zhi-Jie Zheng; Mohammad H Forouzanfar; Mohsen Naghavi; George A Mensah; Majid Ezzati; Christopher J L Murray Journal: Circulation Date: 2013-12-17 Impact factor: 29.690
Authors: Martin Grond; Marek Jauss; Gerhard Hamann; Erwin Stark; Roland Veltkamp; Darius Nabavi; Markus Horn; Christian Weimar; Martin Köhrmann; Rolf Wachter; Ludger Rosin; Paulus Kirchhof Journal: Stroke Date: 2013-10-15 Impact factor: 7.914
Authors: Alvaro Alonso; Bouwe P Krijthe; Thor Aspelund; Katherine A Stepas; Michael J Pencina; Carlee B Moser; Moritz F Sinner; Nona Sotoodehnia; João D Fontes; A Cecile J W Janssens; Richard A Kronmal; Jared W Magnani; Jacqueline C Witteman; Alanna M Chamberlain; Steven A Lubitz; Renate B Schnabel; Sunil K Agarwal; David D McManus; Patrick T Ellinor; Martin G Larson; Gregory L Burke; Lenore J Launer; Albert Hofman; Daniel Levy; John S Gottdiener; Stefan Kääb; David Couper; Tamara B Harris; Elsayed Z Soliman; Bruno H C Stricker; Vilmundur Gudnason; Susan R Heckbert; Emelia J Benjamin Journal: J Am Heart Assoc Date: 2013-03-18 Impact factor: 5.501
Authors: Antonio Luiz P Ribeiro; Milena S Marcolino; Ronald J Prineas; Maria Fernanda Lima-Costa Journal: J Am Heart Assoc Date: 2014-02-07 Impact factor: 5.501
Authors: Enia Lucia Coutinho; Fernando A M Herbella; Carlos Alexandre Volponi Lovato; Marco G Patti; Francisco Schlottmann; Angelo Amato Vincenzo de Paola Journal: World J Surg Date: 2018-05 Impact factor: 3.352
Authors: Gláucia Maria Moraes de Oliveira; Luisa Campos Caldeira Brant; Carisi Anne Polanczyk; Deborah Carvalho Malta; Andreia Biolo; Bruno Ramos Nascimento; Maria de Fatima Marinho de Souza; Andrea Rocha De Lorenzo; Antonio Aurélio de Paiva Fagundes Júnior; Beatriz D Schaan; Fábio Morato de Castilho; Fernando Henpin Yue Cesena; Gabriel Porto Soares; Gesner Francisco Xavier Junior; Jose Augusto Soares Barreto Filho; Luiz Guilherme Passaglia; Marcelo Martins Pinto Filho; M Julia Machline-Carrion; Marcio Sommer Bittencourt; Octavio M Pontes Neto; Paolo Blanco Villela; Renato Azeredo Teixeira; Roney Orismar Sampaio; Thomaz A Gaziano; Pablo Perel; Gregory A Roth; Antonio Luiz Pinho Ribeiro Journal: Arq Bras Cardiol Date: 2022-01 Impact factor: 2.000
Authors: Maria Auxiliadora Parreiras Martins; Amanda Fonseca de Medeiros; Claudmeire Dias Carneiro de Almeida; Adriano Max Moreira Reis Journal: Drugs Ther Perspect Date: 2020-07-31
Authors: Gláucia Maria Moraes de Oliveira; Luisa Campos Caldeira Brant; Carisi Anne Polanczyk; Andreia Biolo; Bruno Ramos Nascimento; Deborah Carvalho Malta; Maria de Fatima Marinho de Souza; Gabriel Porto Soares; Gesner Francisco Xavier Junior; M Julia Machline-Carrion; Marcio Sommer Bittencourt; Octavio M Pontes Neto; Odilson Marcos Silvestre; Renato Azeredo Teixeira; Roney Orismar Sampaio; Thomaz A Gaziano; Gregory A Roth; Antonio Luiz Pinho Ribeiro Journal: Arq Bras Cardiol Date: 2020-09 Impact factor: 2.667
Authors: Emanoela Lima Freitas; Elieusa E Silva Sampaio; Márcia Maria Carneiro Oliveira; Lucas Hollanda Oliveira; Marcos Sergio da Silva Guimarães; Jussara de Oliveira Pinheiro; Luís Pereira de Magalhães; Guisela Steffen Bonadie Albuquerque; Cristiano Macedo; Roque Aras Journal: Arq Bras Cardiol Date: 2020-12 Impact factor: 2.000
Authors: Gabriela M M Paixão; Luis Gustavo S Silva; Paulo R Gomes; Emilly M Lima; Milton P F Ferreira; Derick M Oliveira; Manoel H Ribeiro; Antonio H Ribeiro; Jamil S Nascimento; Jéssica A Canazart; Leonardo B Ribeiro; Emelia J Benjamin; Peter W Macfarlane; Milena S Marcolino; Antonio L Ribeiro Journal: Glob Heart Date: 2020-07-28