Burden of disease from atrial fibrillation in adults from seven countries in Latin America

Abstract

Luz Cubillos,1 Alexandra Haddad,2 Andreas Kuznik,3 Joaquin Mould-Quevedo41Medical Affairs, Pfizer Inc., New York, NY, USA; 2Gerente Médico Portafolio Cardiovascular, Dirección Médica, Pfizer Mexico, Mexico City, Mexico; 3Global Health Economics and Outcomes Research, Pfizer Inc., New York, NY, USA; 4Health Economics and Outcomes Research, Latin America and Primary Care, Pfizer Inc., New York, NY, USA The affiliations given here are those from at the time the research was done.Background: While some international studies have published epidemiologic overviews of atrial fibrillation (AF) for the Latin America region, detailed data at the national level are lacking. The aim of this study was to estimate the burden of disease and morbidity associated with AF in adults over 40 years of age in Argentina, Brazil, Chile, Colombia, Mexico, Peru, and Venezuela.Methods: National healthcare system databases for each country in the analysis were used to identify cases of AF during 2010 based on ICD-10 codes. Patient comorbidities and treatment patterns in each country were assessed based on available data and extrapolation from relevant published information where local data were incomplete or unavailable. The prevalence of AF in each country was estimated using country-specific, national census data, and assumptions based on a review of the available literature.Results: Patients in outpatient or hospital care represented over half of the estimated total cases of AF, of whom around 60% were treated as outpatients. Across the seven countries analyzed, 74.5% of AF cases were adults ≥60 years old. However, with increasing age, the proportion of individuals with AF receiving treatment within the national healthcare systems decreased overall across all seven countries. The most commonly reported comorbidities associated with AF included arterial hypertension (51%–57%), heart failure (14.5%–30%), diabetes (12%–36.5%), and stroke (3%–12.7%).Conclusion: This epidemiologic survey quantifies the scale of the challenge posed by AF to the various national healthcare systems in Latin America. Overall, ambulatory patients in the national healthcare systems carry a high risk of developing a stroke, yet a significant proportion of these patients do not receive appropriate anticoagulant therapy.Keywords: Latin America, stroke, atrial fibrillation, burden of disease, epidemiology, anticoagulation