Publication: Atrial fibrillation prevalence and risk profile from novel community-based screening in Thailand: A prospective multi-centre study
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Issued Date
2021
Resource Type
File Type
application/pdf
ISSN
23529067
Other identifier(s)
2-s2.0-85099185785
Rights
Srinakharinwirot University
Rights Holder(s)
มหาวิทยาลัยศรีนครินทรวิโรฒ
Bibliographic Citation
IJC Heart and Vasculature. Vol 32, (2021)
Suggested Citation
Suwanwela N.C., Chutinet A., Autjimanon H., Ounahachok T., Decha-Umphai C., Chockchai S., Indrabhakti S., Kijpaisalratana N., Akarathanawat W., Travanichakul S., Kitjavijitre T., Vongvasinkul P., Kanacharoen I., Bunlikitkul T.O., Charnwut S., Lowres N., Freedman B. Atrial fibrillation prevalence and risk profile from novel community-based screening in Thailand: A prospective multi-centre study. IJC Heart and Vasculature. Vol 32, (2021). doi:10.1016/j.ijcha.2020.100709 Retrieved from: https://hdl.handle.net/20.500.14740/4425
Abstract
Background: In Thailand, almost one-quarter of strokes are related to atrial fibrillation (AF), and many could be prevented if AF were diagnosed and treated prior to the stroke. Therefore, we tested a novel strategy to screen large numbers of community residents using village health volunteers and primary care nurses. Methods: Local primary care nurses and village health volunteers in Phetchaburi and Lopburi provinces, Thailand were trained to perform AF screening using a blood pressure device with AF algorithm (Microlife A200 AFib). 10% of residents aged ≥ 65 years were randomly selected for screening during home-visits. Participants with possible AF were given follow-up appointments for further testing, including 12-lead ECG and echocardiogram. Results: Over two-months, 9.7% (13,864/143,478) of the target population were screened: mean age 73.2 ± 6.4 years, 32.4% male. The estimated AF prevalence (detected by Microlife A200 AFib) was 2.8% (95% CI, 2.6–3.1%) for age ≥ 65 years (i.e. 393/13,864 participants). Prevalence increased with age from 1.9% (65–69 years) to 5.0% (≥85 years) (p < 0.001). Only 58% (226/393) of participants with suspected AF attended the follow-up appointment (1–3 months after initial screen): mean CHA2DS2-VASc score 3.2 ± 1.2; 86.3% (195/226) had Class-1 oral anticoagulation recommendation, and 33% (75/226) had AF on 12-lead ECG. Conclusions: In Thailand, large-scale AF screening in the community is feasible using trained volunteer health workers, allowing screening of large numbers in a short time-period. Further investigation of this strategy is warranted, ensuring mechanisms to obtain a timely rhythm strip or 12-lead ECG locally, and a designated pathway to treatment. © 2020
Subject(s)
Anticoagulant agent
Digoxin
RNA 16S
Aged
Anticoagulation
Article
Atrial fibrillation
Barthel index
Blood pressure meter
Blood pressure monitoring
Cerebrovascular accident
CHA2DS2-VASc score
Clinical outcome
Controlled study
Daily life activity
Diastolic blood pressure
Dyslipidemia
Echocardiography
Female
Follow up
Glucose blood level
Health disparity
Health promotion
Heart auscultation
Heart rate
Human
Hypertension
Major clinical study
Male
Middle aged
Multicenter study
Nurse
Prevalence
Primary medical care
Prospective study
Risk factor
Screening
Systolic blood pressure
Thailand
Thromboembolism
Digoxin
RNA 16S
Aged
Anticoagulation
Article
Atrial fibrillation
Barthel index
Blood pressure meter
Blood pressure monitoring
Cerebrovascular accident
CHA2DS2-VASc score
Clinical outcome
Controlled study
Daily life activity
Diastolic blood pressure
Dyslipidemia
Echocardiography
Female
Follow up
Glucose blood level
Health disparity
Health promotion
Heart auscultation
Heart rate
Human
Hypertension
Major clinical study
Male
Middle aged
Multicenter study
Nurse
Prevalence
Primary medical care
Prospective study
Risk factor
Screening
Systolic blood pressure
Thailand
Thromboembolism