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Original Research: Cardiovascular Disease |

The Global Burden of Atrial Fibrillation and StrokeThe Global Burden of Atrial Fibrillation: A Systematic Review of the Epidemiology of Atrial Fibrillation in Regions Outside North America and Europe

Gregory Y. H. Lip, MD; Carolyn M. Brechin, PhD; Deirdre A. Lane, PhD
Author and Funding Information

From the University of Birmingham Centre for Cardiovascular Sciences (Drs Lip and Lane), City Hospital, Birmingham; and the Research Evaluation Unit (Dr Brechin), Oxford PharmaGenesis Ltd, Oxford, England.

Correspondence to: Gregory Y. H. Lip, MD, University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, B18 7QH, England; e-mail: g.y.h.lip@bham.ac.uk


For editorial comment see page 1368

Funding/Support: Funding for the systematic literature review was provided by Bayer Healthcare AG.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(6):1489-1498. doi:10.1378/chest.11-2888
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Background:  Although atrial fibrillation (AF) is accepted as the most common sustained cardiac arrhythmia, most published epidemiologic studies focus on predominantly white populations in North America or Europe, and information on AF in nonwhite populations is scarce. The objective of this study was to undertake a systematic review of the published literature on the epidemiology of AF in other regions.

Methods:  Systematic literature searches (MEDLINE; 1990-2010) identified epidemiologic studies reporting on the prevalence or incidence of AF, stroke in AF, risk factors for AF, or the use of antithrombotic therapy in countries outside North America and Europe. This report presents a descriptive analysis of the data; no meta-analysis was planned.

Results:  Many of the 38 articles identified were from the Far East, although Australia, New Zealand, the Middle East, and South America were also represented. The reported prevalence of AF varied among countries, with different ranges in community- and hospital-based studies (0.1%-4% and 2.8%-14%, respectively). The use of anticoagulant therapy varied widely among countries and studies, as did the reported prevalence of stroke in patients with AF (2.8%-24.2%).

Conclusions:  High-quality epidemiologic studies are clearly required to improve understanding of the worldwide burden of AF and stroke in AF. Major improvements in the provision of thromboprophylaxis are also needed in many countries, given the high proportion of untreated patients who are, hence, at risk of stroke.

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