Unmet Stroke Prevention Needs in Atrial Fibrillation in Asia
Journal name: The Malaysian Journal of Medical Sciences
Original article title: The Unmet Need of Stroke Prevention in Atrial Fibrillation in the Far East and South East Asia
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:
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Yutao Guo, Gregory Y.H.Lip, Stavros Apostolakis
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: The Unmet Need of Stroke Prevention in Atrial Fibrillation in the Far East and South East Asia
Year: 2012
Copyright (license): CC BY 4.0
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Summary of article contents:
Introduction
Atrial fibrillation (AF) is recognized as the most prevalent sustained cardiac arrhythmia, posing significant risks of stroke and systemic thromboembolism that lead to notable morbidity and mortality. In the Far East and South East Asia, as reported in various studies, the burden of AF is considerable, similar to that documented in North America and Europe. Current data indicate that hypertension is the most common risk factor associated with AF in this region, followed by coronary heart disease and diabetes mellitus. Alarmingly, the uptake of anticoagulant therapy remains low, ranging from 0.5% to 28% in countries such as Malaysia, Singapore, and China, contributing to a heightened incidence of AF-related strokes.
Importance of Risk Assessment in AF Management
An essential framework for managing AF is the CHA2DS2-VASc score, which serves as a tool for assessing stroke risk. This score helps identify "truly low-risk" patients who might not require antithrombotic therapy, while those with one or more stroke risk factors are recommended for oral anticoagulation. Recent shifts in focus emphasize the need for better risk assessment, incorporating both thromboembolic and bleeding risks. The adoption of the HAS-BLED score in conjunction with the CHA2DS2-VASc score enhances clinical decision-making, ensuring that healthcare providers can better balance the benefits of anticoagulation against potential bleeding complications.
Conclusion
Oral anticoagulation is crucial in the effective management of atrial fibrillation, particularly for patients who are not classified as low risk. With both the CHA2DS2-VASc and HAS-BLED scores aiding in risk stratification, healthcare practices can improve the identification and treatment of patients in need of stroke prevention. The limited data available highlight that AF-related strokes pose a significant healthcare burden in the Far East and South East Asia, suggesting an urgent need for improved anticoagulation strategies. The ongoing advancements in new oral anticoagulants are expected to further facilitate effective stroke prevention efforts in this region, ultimately reflecting a positive shift in clinical practice.
FAQ section (important questions/answers):
What are the common risk factors for atrial fibrillation in Asia?
Hypertension is the most prevalent risk factor for atrial fibrillation (AF) in Asia, alongside coronary heart disease and diabetes mellitus. A significant portion of patients with AF also has hypertension, with varying rates across different countries in the region.
How effective are current anticoagulant therapies for AF in Asia?
Anticoagulant therapy use in Asia is notably low, ranging from 0.5% to 28%. Many patients with AF are not receiving appropriate antithrombotic therapy, increasing the risk of stroke and thromboembolic events.
What is the CHA2DS2-VASc score and its importance for AF?
The CHA2DS2-VASc score helps identify patients with atrial fibrillation at low risk for stroke, guiding decisions about anticoagulation therapy. It enhances risk assessment compared to the older CHADS2 score, allowing better treatment planning.
What are the benefits of new oral anticoagulants for AF management?
New oral anticoagulants simplify treatment for atrial fibrillation, eliminating the need for frequent monitoring associated with warfarin. They are expected to improve outcomes by enhancing adherence to stroke prevention strategies in populations with AF.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Unmet Stroke Prevention Needs in Atrial Fibrillation in Asia”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Male:
The term 'male' is relevant in the context of atrial fibrillation (AF) as studies indicate that men have a higher prevalence of AF compared to women. This gender difference in risk factors, including hypertension and coronary heart disease, underscores the need for tailored prevention strategies in managing AF-related complications.
2) Table:
Tables in academic articles organize data systematically, allowing readers to easily digest information such as prevalence rates and study cohorts. In this context, several tables provide critical insights into the incidence of atrial fibrillation, associated risk factors, and anticoagulation treatment patterns across various countries, aiding in comparative analysis.
3) Bleeding:
The term 'bleeding' is crucial when discussing anticoagulation therapy for AF, as anticoagulants increase the risk of bleeding complications. The text highlights the need to balance the risks of stroke versus the bleeding risk using scoring systems like HAS-BLED, which helps clinicians make informed decisions about antithrombotic treatment.
4) Study (Studying):
A 'study' refers to the systematic investigation of a particular aspect of atrial fibrillation, such as its prevalence or management in specific populations. The article references various community and hospital-based studies, providing evidence that informs guidelines for stroke prevention and highlights disparities in treatment across regions.
5) Drug:
'Drug' is significant in the context of anticoagulation therapies used to prevent stroke in AF patients. The article discusses traditional medications such as warfarin and newer oral anticoagulants, emphasizing their effectiveness in managing stroke risk while noting the importance of proper monitoring and patient adherence.
6) Disease:
'Disease' typically refers to atrial fibrillation itself in this context, which is a significant cardiac arrhythmia associated with increased stroke risk and other complications. Understanding disease prevalence and associated factors, like hypertension and coronary heart disease, is essential for developing effective prevention and management strategies for healthcare providers.
7) Cina:
'China' is a focal point of the article as it provides data on the prevalence and management of atrial fibrillation within its population. The article highlights various studies conducted in China, presenting statistics on risk factors and treatment patterns that can inform public health initiatives specific to the region.
8) India:
'India' is mentioned in relation to the lower prevalence rates of atrial fibrillation compared to other Asian countries. The article provides insights into AF statistics and associated healthcare challenges in India, emphasizing the need for improved understanding and management strategies for stroke prevention in this demographic.
9) Chang:
'Chang' refers to one of the authors mentioned in the references discussing atrial fibrillation and its management. His work contributes to the collective understanding of AF, including its epidemiology and treatment approaches, which are essential for developing global guidelines for stroke prevention in AF patients.
10) Doubt:
'Doubt' signifies the uncertainty surrounding stroke risk assessments in patients with atrial fibrillation, particularly among those deemed 'low risk' based on older scoring systems like CHADS2. The article argues for the necessity of updated risk stratification models to better identify and manage all patients with AF effectively.
11) Death:
'Death' is a critical outcome associated with atrial fibrillation, particularly due to the increased risk of stroke and systemic embolism. The article emphasizes the importance of effective anticoagulation therapy in reducing mortality rates among AF patients and highlights the public health implications of AF-related complications.
12) Food:
'Food' interactions are particularly relevant to anticoagulant therapy, especially warfarin, which has dietary restrictions that complicate its use. The article stresses the need for simpler anticoagulation strategies that avoid these complications, promoting new oral anticoagulants that eliminate the need for strict dietary monitoring.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Unmet Stroke Prevention Needs in Atrial Fibrillation in Asia’. Further sources in the context of Science might help you critically compare this page with similair documents:
Diabetes mellitus, South East Asia, Clinical trial, Ischemic Stroke, Aging Population, Coronary heart disease, Epidemiological data, Healthcare burden, Risk factor, Anticoagulant therapy, Bleeding risk, Antithrombotic Therapy, Antiplatelet therapy, Risk stratification, Atrial Fibrillation, Community-based studies, Antithrombotic drugs, Stroke prevention, Thromboprophylaxis, New oral anticoagulants, Thromboembolic risk, Warfarin, Systemic embolism, Cha2ds2-vasc score, Thromboembolism risk, Stroke risk, Oral anticoagulant, Hospital-based studies, Oral anticoagulation.
Concepts being referred in other categories, contexts and sources.