We used a restrictive definition of regular OAC users, that required at least 4 dispenses of prescribed OAC in the pharmacy during a calendar year to be counted while an OAC user, a methodology that we have shown is more effective in detecting noncompliance than standard dispensary based counts

We used a restrictive definition of regular OAC users, that required at least 4 dispenses of prescribed OAC in the pharmacy during a calendar year to be counted while an OAC user, a methodology that we have shown is more effective in detecting noncompliance than standard dispensary based counts.24 This difference in definition of chronic OAC use could account for the difference between these studies and ours. rate of ischemic stroke and death increased with age. The pace of stroke improved from 2 per 1000 person years in individuals with CHA2DS2_VASC SCORE of 0, to 58 per 1000 person years in those with a score of 9. Conclusions In the present study the prevalence and incidence of AF, stroke, and death were comparable to those reported in Europe and North America. The low use of anticoagulation calls for measures to increase adherence to current treatment recommendations in order to improve outcomes. test and the chi\square assessments, respectively. In patients with incident AF, Kaplan\Meier survival analysis was used to create survival curves and describe the risk of ischemic stroke or death over time, following the index date of AF diagnosis. All statistical analyses were performed using the SPSS statistical software version 20 (SPSS Inc, Chicago, IL) and in R version 2.14.2 (R Foundation for Statistical Computing). The study was approved by the central ethics institutional review board of CHS. Results Prevalence and Incidence of AF Prevalence of AF There were 71 644 patients with AF out of 2 414 282 patients on January 1, 2004 giving an overall prevalence of 3.0% in the adult populace older than 21 years. Age and gender specific prevalence (per 100 000 persons) are shown in Physique 1. The crude prevalence rates of AF were 2.91% in men and 3.01% in women. Age adjusted rates were 3.19% (95% CI; 3.16 to 3.23) in men, and 2.79% (95% CI; 2.77 to 2.83) in women ( em P /em 0.001). The prevalence of atrial fibrillation was higher in men as compared with women at any age group (Physique 1), and it increased in both men and women with increasing age. In men it increased from 170.0 per 100 000 patients at risk (0.2%) in those 35 years of age, to 15 184 per 100 000 patients at risk (15.2%) in those 85 years of age. The corresponding prevalence rates in women were 150 (0.15%) per 100 000 in women 35 years of age and 12 577 (12.6%) per 100 000 in women 85 years of age (Physique 1). The increase in prevalence across age groups was highly significant in men and women ( em P /em 0.001). Open in a separate window Physique 1. Prevalence of atrial fibrillation in January 1, 2004, according to age and gender. Baseline Characteristics of Incident AF Cases After excluding the prevalent AF cases among the remaining AF\free adult populace (n=2 342 638) we were able to identify between January RECA 1, 2004 to December 31, 2011, 116 637 patients with incident new AF who met the inclusion criteria. After excluding patients with significant valvular disease and previous valve surgery (n=17 826) we remained with a cohort of 98 811 patients with incident new non\valvular AF (Physique 2). Open in a separate window Physique 2. Study populace of incident atrial fibrillation cases between 2004 and 2012. Age\ and gender\specific incidence rates are given in Physique 3. The incidence (per 10 000 person 12 months at risk) of AF was 635 in men as compared with 575 in women. Corresponding age\adjusted incidence rates were 699 (95% CI, 693 to 704) in men as compared with 529 (95% CI, 524 to 533) in women em P /em 0.0001. The incidence was significantly higher among men at any age group and it increased from 47.7 at age 35 to 4427.6 in men 85 years of age and from 36.7 at age 35 to 3790 in women 85 years of age (Determine 3). The increase in incidence across age.The rate of persistent warfarin use (dispensed for 3 months in a calendar year) was low (25.7%) and it increased with increasing stroke risk score. person years in patients with CHA2DS2_VASC SCORE of 0, to 58 per 1000 person years in those with a score of SPD-473 citrate 9. Conclusions In the present study the prevalence and incidence of AF, stroke, and death were comparable to those reported in Europe and North America. The low use of anticoagulation calls for measures to increase adherence to current treatment recommendations in order to improve outcomes. test and the chi\square assessments, respectively. In patients with incident AF, Kaplan\Meier survival analysis was used to create survival curves and describe the risk of ischemic stroke or death over time, following the SPD-473 citrate index date of AF diagnosis. All statistical analyses were performed using the SPSS statistical software version 20 (SPSS Inc, Chicago, IL) and in R version 2.14.2 (R Foundation for Statistical Computing). The study was approved by the central ethics institutional review board of CHS. Results Prevalence and Incidence of AF Prevalence of AF There were 71 644 patients with AF out of 2 414 282 patients on January 1, 2004 giving an overall prevalence of 3.0% in the adult populace older than 21 years. Age and gender specific prevalence (per 100 000 persons) are shown in Physique 1. The crude prevalence rates of AF were 2.91% in men and 3.01% in women. Age adjusted rates were 3.19% (95% CI; 3.16 to 3.23) in men, and 2.79% (95% CI; 2.77 to 2.83) in women ( em P /em 0.001). The prevalence of atrial fibrillation was higher in men as compared with women at any age group (Physique 1), and it increased in both men and women with increasing age. In men it increased from 170.0 per 100 000 patients at risk (0.2%) in those 35 years of age, to 15 184 per 100 000 patients at risk (15.2%) in those 85 years of age. The corresponding prevalence rates in women were 150 (0.15%) per 100 000 in women 35 years of age and 12 577 (12.6%) per 100 000 in women 85 years of age (Physique 1). The increase in prevalence across age groups was highly significant in men and women ( em P /em 0.001). Open in a separate window Physique 1. Prevalence of atrial fibrillation in January 1, 2004, according to age and gender. Baseline Characteristics of Incident AF Cases After excluding the prevalent AF cases among the remaining AF\free adult populace (n=2 342 638) we were able to identify between January 1, 2004 to December 31, 2011, 116 637 patients with incident new AF who met the inclusion criteria. After excluding patients with significant valvular disease and previous valve surgery (n=17 826) we remained with a cohort of 98 811 patients with incident new non\valvular AF (Physique 2). Open in a separate window Physique 2. Study populace of incident atrial fibrillation cases between 2004 and 2012. Age\ and gender\specific incidence rates are given in Physique 3. The incidence (per 10 000 person 12 months at risk) of AF was 635 in men as compared with 575 in women. Corresponding age\adjusted incidence rates were 699 (95% CI, 693 to 704) in men as compared with 529 (95% CI, 524 to 533) in women em P /em 0.0001. The incidence was significantly SPD-473 citrate higher among men at any age group and it increased from 47.7 at age 35 to 4427.6 in.