Stroke and Ageing Research Centre, Department of Medicine, Monash Medical Centre, Southern Clinical School, Monash University, Melbourne, Vic., Australia.
Neuroepidemiology. 2013;40(4):227-39. doi: 10.1159/000343667. Epub 2013 Jan 24.
Atrial fibrillation (AF) is a major risk factor for stroke, especially in the elderly. Increased life expectancies mean that AF-related stroke is a growing global public health concern. Improvements in the detection, treatment and prevention of the consequences of AF have occurred in recent years. However, the extent to which these improvements have impacted on the prevalence of AF, the risk of AF-related stroke and subsequent economic costs are unknown. This review provides a contemporary assessment of the epidemiological data on AF-related stroke aimed at assessing the effectiveness of primary prevention strategies and associated economic implications with reductions in stroke incidence. A systematic review of the literature was performed. Appropriately designed studies were identified and retrieved. Evidence on changes in the prevalence of AF, the risk of stroke associated with AF and the excess cost of AF-related stroke over the last 30 years was summarised. The results provide evidence that the age-adjusted prevalence of AF and the relative risk of stroke associated with AF has remained relatively constant. Unless action is taken to improve detection of AF and reduce its consequences, a considerable increase in the social and economic burden associated with AF-related stroke is likely.
心房颤动（AF）是中风的一个主要危险因素，尤其是在老年人中。预期寿命的延长意味着与 AF 相关的中风是一个日益严重的全球公共卫生问题。近年来，在 AF 的检测、治疗和预防后果方面已经取得了一些进展。然而，这些改进在多大程度上影响了 AF 的患病率、AF 相关中风的风险以及随后的经济成本尚不清楚。本综述提供了 AF 相关中风的流行病学数据的最新评估，旨在评估初级预防策略的有效性及其与中风发病率降低相关的经济影响。进行了系统的文献综述。确定并检索了设计适当的研究。总结了过去 30 年来 AF 的患病率变化、与 AF 相关的中风风险以及 AF 相关中风的超额成本的证据。结果表明，AF 的年龄调整患病率和与 AF 相关的中风风险的相对风险相对稳定。除非采取措施提高 AF 的检出率并降低其后果，否则与 AF 相关的中风相关的社会和经济负担很可能会大幅增加。
