Diagnóstico de Fibrilação Atrial na Comunidade Utilizando Eletrocardiograma e Autorrelato: Análise Transversal do ELSA-Brasil

Itamar S Santos; Paulo A Lotufo; Luisa Brant; Marcelo M Pinto Filho; Alexandre da Costa Pereira; Sandhi Maria Barreto; Antonio L Ribeiro; G Neil Thomas; Gregory Y H Lip; Isabela M Bensenor

doi:10.36660/abc.20190873

Diagnóstico de Fibrilação Atrial na Comunidade Utilizando Eletrocardiograma e Autorrelato: Análise Transversal do ELSA-Brasil

Translated title of the contribution: Atrial fibrillation diagnosis using ECG records and self-report in the community: cross-sectional analysis from ELSA-Brasil

Itamar S Santos, Paulo A Lotufo, Luisa Brant, Marcelo M Pinto Filho, Alexandre da Costa Pereira, Sandhi Maria Barreto, Antonio L Ribeiro, G Neil Thomas, Gregory Y H Lip, Isabela M Bensenor

Applied Health Research

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Abstract

BACKGROUND: Atrial fibrillation or flutter (AFF) is the most common sustained cardiac arrhythmia. Limited data can be found on AFF epidemiology in South America.

OBJECTIVE: The present study sought to describe the clinical epidemiology of AFF and the use of stroke prevention medication in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline assessment.

METHODS: This study analyzed data from 13,260 ELSA-Brasil participants. AFF was defined according to ECG recording or by self-report. Logistic regression models were built to analyze factors associated with AFF. This study also analyzed if age and sex were associated with anticoagulant use for stroke prevention. Significance level was set at 5%.

RESULTS: Median age was 51 years and 7,213 (54.4%) participants were women. AFF was present in 333 (2.5%) participants. Increasing age (odds ratio [OR]:1.05; 95% confidence interval [95%CI]: 1.04-1.07), hypertension (OR:1.44; 95%CI: 1.14-1.81), coronary heart disease (OR: 5.11; 95%CI: 3.85-6.79), heart failure (OR:7.37; 95%CI: 5.00-10.87), and rheumatic fever (OR:3.38; 95%CI: 2.28-5.02) were associated with AFF. From 185 participants with AFF and a CHA2DS2-VASc score ≥2, only 20 (10.8%) used anticoagulants (50.0% among those with AFF in the baseline ECG). Stroke prevention in this group was associated with a higher age (1.8% vs 17.7% in those aged ≤ 54 and ≥ 65 years, respectively; p=0.013). A trend towards a reduced anticoagulant use was observed in women (7.1% vs. 16.4% in women and men, respectively; p=0.055).

CONCLUSIONS: At the ELSA-Brasil baseline, 2.5% of the participants had AFF. The lack of stroke prevention was common, which is an especially challenging point for healthcare in this setting.

Translated title of the contribution	Atrial fibrillation diagnosis using ECG records and self-report in the community: cross-sectional analysis from ELSA-Brasil
Original language	Portuguese
Pages (from-to)	426-434
Number of pages	9
Journal	Arquivos brasileiros de cardiologia
Volume	117
Issue number	3
DOIs	https://doi.org/10.36660/abc.20190873
Publication status	Published - 1 Sept 2021

Bibliographical note

Funding Information:
This study was partially funded by the Brazilian Ministry of Health (Science and Technology Department) and the Brazilian Ministry of Science and Technology (Financiadora de Estudos e Projetos and CNPq National Research Council) (grants 01 06 0010.00 RS, 01 06 0212.00 BA, 01 06 0300.00 ES, 01 06 0278.00 MG, 01 06 0115.00 SP, 01 06 0071.00 RJ).

Publisher Copyright:
© 2021, Arquivos Brasileiros de Cardiologia. All rights reserved.

Keywords

Adult
Aged
Anticoagulants/therapeutic use
Atrial Fibrillation/diagnosis
Cross-Sectional Studies
Electrocardiography
Female
Humans
Longitudinal Studies
Male
Middle Aged
Risk Assessment
Risk Factors
Self Report
Stroke/diagnosis

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10.36660/abc.20190873Licence: Creative Commons: Attribution (CC BY)

SantosI2021AtrialFinal published version, 347 KBLicence: Creative Commons: Attribution (CC BY)

Cite this

Santos, I. S., Lotufo, P. A., Brant, L., Pinto Filho, M. M., Pereira, A. D. C., Barreto, S. M., Ribeiro, A. L., Thomas, G. N., Lip, G. Y. H., & Bensenor, I. M. (2021). Diagnóstico de Fibrilação Atrial na Comunidade Utilizando Eletrocardiograma e Autorrelato: Análise Transversal do ELSA-Brasil. Arquivos brasileiros de cardiologia, 117(3), 426-434. https://doi.org/10.36660/abc.20190873

@article{89c94a63d2d2413da619ab43b27534b2,

title = "Diagn{\'o}stico de Fibrila{\c c}{\~a}o Atrial na Comunidade Utilizando Eletrocardiograma e Autorrelato: An{\'a}lise Transversal do ELSA-Brasil",

abstract = "BACKGROUND: Atrial fibrillation or flutter (AFF) is the most common sustained cardiac arrhythmia. Limited data can be found on AFF epidemiology in South America.OBJECTIVE: The present study sought to describe the clinical epidemiology of AFF and the use of stroke prevention medication in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline assessment.METHODS: This study analyzed data from 13,260 ELSA-Brasil participants. AFF was defined according to ECG recording or by self-report. Logistic regression models were built to analyze factors associated with AFF. This study also analyzed if age and sex were associated with anticoagulant use for stroke prevention. Significance level was set at 5%.RESULTS: Median age was 51 years and 7,213 (54.4%) participants were women. AFF was present in 333 (2.5%) participants. Increasing age (odds ratio [OR]:1.05; 95% confidence interval [95%CI]: 1.04-1.07), hypertension (OR:1.44; 95%CI: 1.14-1.81), coronary heart disease (OR: 5.11; 95%CI: 3.85-6.79), heart failure (OR:7.37; 95%CI: 5.00-10.87), and rheumatic fever (OR:3.38; 95%CI: 2.28-5.02) were associated with AFF. From 185 participants with AFF and a CHA2DS2-VASc score ≥2, only 20 (10.8%) used anticoagulants (50.0% among those with AFF in the baseline ECG). Stroke prevention in this group was associated with a higher age (1.8% vs 17.7% in those aged ≤ 54 and ≥ 65 years, respectively; p=0.013). A trend towards a reduced anticoagulant use was observed in women (7.1% vs. 16.4% in women and men, respectively; p=0.055).CONCLUSIONS: At the ELSA-Brasil baseline, 2.5% of the participants had AFF. The lack of stroke prevention was common, which is an especially challenging point for healthcare in this setting.",

keywords = "Adult, Aged, Anticoagulants/therapeutic use, Atrial Fibrillation/diagnosis, Cross-Sectional Studies, Electrocardiography, Female, Humans, Longitudinal Studies, Male, Middle Aged, Risk Assessment, Risk Factors, Self Report, Stroke/diagnosis",

author = "Santos, {Itamar S} and Lotufo, {Paulo A} and Luisa Brant and {Pinto Filho}, {Marcelo M} and Pereira, {Alexandre da Costa} and Barreto, {Sandhi Maria} and Ribeiro, {Antonio L} and Thomas, {G Neil} and Lip, {Gregory Y H} and Bensenor, {Isabela M}",

note = "Funding Information: This study was partially funded by the Brazilian Ministry of Health (Science and Technology Department) and the Brazilian Ministry of Science and Technology (Financiadora de Estudos e Projetos and CNPq National Research Council) (grants 01 06 0010.00 RS, 01 06 0212.00 BA, 01 06 0300.00 ES, 01 06 0278.00 MG, 01 06 0115.00 SP, 01 06 0071.00 RJ). Publisher Copyright: {\textcopyright} 2021, Arquivos Brasileiros de Cardiologia. All rights reserved.",

year = "2021",

month = sep,

day = "1",

doi = "10.36660/abc.20190873",

language = "Portuguese",

volume = "117",

pages = "426--434",

journal = "Arquivos brasileiros de cardiologia",

issn = "0066-782X",

number = "3",

}

Santos, IS, Lotufo, PA, Brant, L, Pinto Filho, MM, Pereira, ADC, Barreto, SM, Ribeiro, AL, Thomas, GN , Lip, GYH & Bensenor, IM 2021, 'Diagnóstico de Fibrilação Atrial na Comunidade Utilizando Eletrocardiograma e Autorrelato: Análise Transversal do ELSA-Brasil', Arquivos brasileiros de cardiologia, vol. 117, no. 3, pp. 426-434. https://doi.org/10.36660/abc.20190873

TY - JOUR

T1 - Diagnóstico de Fibrilação Atrial na Comunidade Utilizando Eletrocardiograma e Autorrelato

T2 - Análise Transversal do ELSA-Brasil

AU - Santos, Itamar S

AU - Lotufo, Paulo A

AU - Brant, Luisa

AU - Pinto Filho, Marcelo M

AU - Pereira, Alexandre da Costa

AU - Barreto, Sandhi Maria

AU - Ribeiro, Antonio L

AU - Thomas, G Neil

AU - Lip, Gregory Y H

AU - Bensenor, Isabela M

N1 - Funding Information: This study was partially funded by the Brazilian Ministry of Health (Science and Technology Department) and the Brazilian Ministry of Science and Technology (Financiadora de Estudos e Projetos and CNPq National Research Council) (grants 01 06 0010.00 RS, 01 06 0212.00 BA, 01 06 0300.00 ES, 01 06 0278.00 MG, 01 06 0115.00 SP, 01 06 0071.00 RJ). Publisher Copyright: © 2021, Arquivos Brasileiros de Cardiologia. All rights reserved.

PY - 2021/9/1

Y1 - 2021/9/1

N2 - BACKGROUND: Atrial fibrillation or flutter (AFF) is the most common sustained cardiac arrhythmia. Limited data can be found on AFF epidemiology in South America.OBJECTIVE: The present study sought to describe the clinical epidemiology of AFF and the use of stroke prevention medication in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline assessment.METHODS: This study analyzed data from 13,260 ELSA-Brasil participants. AFF was defined according to ECG recording or by self-report. Logistic regression models were built to analyze factors associated with AFF. This study also analyzed if age and sex were associated with anticoagulant use for stroke prevention. Significance level was set at 5%.RESULTS: Median age was 51 years and 7,213 (54.4%) participants were women. AFF was present in 333 (2.5%) participants. Increasing age (odds ratio [OR]:1.05; 95% confidence interval [95%CI]: 1.04-1.07), hypertension (OR:1.44; 95%CI: 1.14-1.81), coronary heart disease (OR: 5.11; 95%CI: 3.85-6.79), heart failure (OR:7.37; 95%CI: 5.00-10.87), and rheumatic fever (OR:3.38; 95%CI: 2.28-5.02) were associated with AFF. From 185 participants with AFF and a CHA2DS2-VASc score ≥2, only 20 (10.8%) used anticoagulants (50.0% among those with AFF in the baseline ECG). Stroke prevention in this group was associated with a higher age (1.8% vs 17.7% in those aged ≤ 54 and ≥ 65 years, respectively; p=0.013). A trend towards a reduced anticoagulant use was observed in women (7.1% vs. 16.4% in women and men, respectively; p=0.055).CONCLUSIONS: At the ELSA-Brasil baseline, 2.5% of the participants had AFF. The lack of stroke prevention was common, which is an especially challenging point for healthcare in this setting.

AB - BACKGROUND: Atrial fibrillation or flutter (AFF) is the most common sustained cardiac arrhythmia. Limited data can be found on AFF epidemiology in South America.OBJECTIVE: The present study sought to describe the clinical epidemiology of AFF and the use of stroke prevention medication in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline assessment.METHODS: This study analyzed data from 13,260 ELSA-Brasil participants. AFF was defined according to ECG recording or by self-report. Logistic regression models were built to analyze factors associated with AFF. This study also analyzed if age and sex were associated with anticoagulant use for stroke prevention. Significance level was set at 5%.RESULTS: Median age was 51 years and 7,213 (54.4%) participants were women. AFF was present in 333 (2.5%) participants. Increasing age (odds ratio [OR]:1.05; 95% confidence interval [95%CI]: 1.04-1.07), hypertension (OR:1.44; 95%CI: 1.14-1.81), coronary heart disease (OR: 5.11; 95%CI: 3.85-6.79), heart failure (OR:7.37; 95%CI: 5.00-10.87), and rheumatic fever (OR:3.38; 95%CI: 2.28-5.02) were associated with AFF. From 185 participants with AFF and a CHA2DS2-VASc score ≥2, only 20 (10.8%) used anticoagulants (50.0% among those with AFF in the baseline ECG). Stroke prevention in this group was associated with a higher age (1.8% vs 17.7% in those aged ≤ 54 and ≥ 65 years, respectively; p=0.013). A trend towards a reduced anticoagulant use was observed in women (7.1% vs. 16.4% in women and men, respectively; p=0.055).CONCLUSIONS: At the ELSA-Brasil baseline, 2.5% of the participants had AFF. The lack of stroke prevention was common, which is an especially challenging point for healthcare in this setting.

KW - Adult

KW - Aged

KW - Anticoagulants/therapeutic use

KW - Atrial Fibrillation/diagnosis

KW - Cross-Sectional Studies

KW - Electrocardiography

KW - Female

KW - Humans

KW - Longitudinal Studies

KW - Male

KW - Middle Aged

KW - Risk Assessment

KW - Risk Factors

KW - Self Report

KW - Stroke/diagnosis

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DO - 10.36660/abc.20190873

M3 - Article

C2 - 34550227

SN - 0066-782X

VL - 117

SP - 426

EP - 434

JO - Arquivos brasileiros de cardiologia

JF - Arquivos brasileiros de cardiologia

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ER -

Diagnóstico de Fibrilação Atrial na Comunidade Utilizando Eletrocardiograma e Autorrelato: Análise Transversal do ELSA-Brasil

Abstract

Bibliographical note

Keywords

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