1. ABS Tortosa-Est Primary Care, Family and Comunity Specialist, Catalan Institute of Health, Regional Management Terres de l'Ebre, CAP Temple, Place carrilet,Tortosa-Spain.
2. Department of Research, ICS Terres de l'Ebre, Hospital de Tortosa Verge de la Cinta, Tarragona, Spain.
3. IDIAP Institute for Research in Primary Care (IDIAP) Barcelona, Spain.
5. Antares Consulting HEOR, Barcelona, Spain.
6. Health Economics, Boehringer-Ingelheim España, Sant Cugat del Vallès, Barcelona, Spain.
7. Department of Cardiology, Tortosa Verge Cinta Hospital, Tortosa Verge Cinta Hospital, Tarragona, Spain.
8. Director of Catalonia Cerebral Vascular Disease, Health Department of the Government of Catalonia, Barcelona, Spain.
Background: Undiagnosed atrial fibrillation usually is only detected with the first complication. We estimated undiagnosed Atrial Fibrillation prevalence, overall AF and associated factors in a public health-service area in Catalonia, north-eastern Spain.
Methods: Multicentre, cross-sectional study, with people randomly selected among the attended population over 60 years old by primary care teams regardless of follow-up time in health centres or at homes. Information was collected through ECGs, electronic medical history reviews and medical interviews. Descriptive and logistic regression analysis was performed.
Results: 1043 subjects were recruited (47.1% male), mean age: 73.1 y-o (SD: 7.8 y-o); 43.3% ≥75-year-old. Overall AF prevalence was 10.9% (CI95% 9.1-12.8%); higher in men than in women, progressively increasing with age (24.4% in ≥85-year-old). Only women ≥85-year-old had higher prevalence (26.2%) than men (22.5%). Undiagnosed AF relative prevalence was 2.2% (IC95% 1.3-3.1%). These results show that about 1 in 50 people over 60 years old could suffer undiagnosed AF. The higher risk of AF undiagnosed was found in: men (OR 2.5 IC95% 1.0-6.2), >75 years old (OR 2.5 IC95% 1.0-6.1), heart failure history (OR 5.2 IC95% 1.3-20.9), who live in rural areas (OR 15.9 IC95% 1.5-160.1) and to whom no one ECG was performed in the last two years.
Conclusions: The overall AF prevalence increased 10 times from the sixties to over eighties and the proportion man-woman changes from 4:1 to 1:1. The undiagnosed AF prevalence was 2.2% (IC95% 1.3-3.1). This percentage should be added to the one of untreated cases with OAC.
Keywords: Atrial fibrillation, prevalence, elderly people, diagnosed, undiagnosed, primary care