Atrial fibrillation: improvement in identification and stroke preventive therapy - data from the UK Clinical Practice Research Datalink, 2000-2012

Abstract

Objective: To investigate recent trends in the diagnosis and treatment of atrial fibrillation.

Methods: Time trend analysis in the UK Clinical Practice Research Datalink (CPRD -previously the GPRD), 2000-2012.

Results: The incidence of AF in men rose from 1.274 (1.271, 1.276) per 1 000 patient years in 2000 to 1.972 (1.969, 1.975) in 2012. In women, it rose from 1.209 (1.207, 1.211) to 1.609 (1.606, 1.611). 55847 patients with AF first diagnosed between 2000 and 2012 were included in the study. 54% of men were initiated on anticoagulation therapy in the first year following diagnosis of atrial fibrillation, compared to 45% of women (P<0.0001). This increased from 48% in men and 40% in women in 2000 to 58% in men and 52% in women in 2012.

Conclusions: Identification of atrial fibrillation has improved in recent years, as has treatment for stroke prevention. Although there has historically been a bias towards men in the treatment of stroke prevention in atrial fibrillation, this study shows that the gap has been closing in recent years. Despite this improvement, this study shows that there are still many patients with atrial fibrillation who are not treated optimally to prevent stroke.

Keywords: CPRD; UK; atrial fibrillation; epidemiology; primary care; stroke prevention.