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KMID : 1011920140150020017
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International Journal of Arrhythmia
2014 Volume.15 No. 2 p.17 ~ p.24
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Epidemiologic Features of the Korean Atrial Fibrillation Population in a Single Center
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Cha Myung-Jin
Oh Se-Il
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Abstract
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Background: Recent atrial fibrillation (AF) epidemiology data mostly depends on small Western population cohorts. By contrast, available data for the Korean AF population is limited. We sought to evaluate, in a singlecenter study, both annual trends in AF diagnosis and management and related changes in stroke risk factor components.
Methods: We retrospectively reviewed, in consecutive order, the medical records of 15,593 patients in a single center who were diagnosed with AF between 2000 and 2012. Patients under 18 years of age were excluded from the study. Patients were grouped by their year of diagnosis into 3 categories: 2000-2003 was considered period 1, 2004-2007 was period 2 and 2008?2012 was period 3.
Results: We found in our study population that the proportion of valvular AF had decreased year-over-year when comparing period 1 to periods 2 and 3 (16.1%→9.9%→6.0%). In addition, the age at diagnosis increased annually (age≥75 years, 14.0%→17.8%→24.4%). We noted that the composition of risk factors in the CHADS2 and CHA2DS2-VASc scoring systems has also changed, old age becoming increasingly important. When evaluating treatment approaches, we found that a single antiplatelet agent was most frequently used in non-valvular AF patients with CHADS2 score 1 (44.2%), followed-in decreasing order of prevalence-by no medication (28.4%), an anticoagulation agent (26.7%) and a combination of an antiplatelet and an anticoagulation agent (1.6%). Although all of the valvular AF patients in our study who had undergone mitral valve surgery were treated with an agent (e.g. warfarin or Vit. K antagonist), slightly more than a quarter (26.4%) of patients who did not undergo surgery were treated with anticoagulation therapy.
Conclusions: The epidemiology of the Korean AF population continues to evolve, and a trend of decreasing valvular AF is apparent. Most valvular AF patients in our study had been undertreated in terms of anticoagulation. Physicians should be more aware of patients’ age to determine the optimal initial stroke prevention strategy.
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KEYWORD
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Korean, atrial fibrillation, stroke, risk factor, epidemiology
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