Atrial Fibrillation: The Epidemic of the New Millennium
Authors: Michael D. Ezekowitz
Journal: Annals of Internal Medicine (1999)

Editorials5 October 1999Atrial Fibrillation: The Epidemic of the New MillenniumMichael D. Ezekowitz, MD, PhDMichael D. Ezekowitz, MD, PhDYale University School of Medicine; New Haven, CT 06510 (Ezekowitz)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-7-199910050-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail By the year 2030, the number of Americans older than 65 years of age will double. Approximately 4% of persons 65 years of age will have atrial fibrillation, and this percentage will increase to approximately 15% at age 75 (1, 2). These data have important implications for the health care system. Most of this growing population of patients will need a simple, cost-effective treatment strategy that can be managed in a primary care setting.In this issue, Hart and colleagues (3) review stroke prevention trials in patients with atrial fibrillation and confirm the well-described, consistent benefit of warfarin over both ...References1. Hobbs F, Damon BL, Taeuber CM. Sixty-five plus in the United States. Current Population Reports, Special Studies, no. P23-190. Washington, DC: U.S. Dept. of Commerce, Economics, and Statistics Administration, Bureau of the Census; 1996. Google Scholar2. Kannel WB, Abbott RD, Savage DD, McNamara PM. Epidemiologic features of chronic atrial fibrillation: the Framingham study. N Engl J Med. 1982;306:1018-22. CrossrefMedlineGoogle Scholar3. Hart RG, Benavente O, McBride R, Pearce LA. Antithrombotic therapy to prevent stroke in patients with atrial fibrillation: a meta-analysis. Ann Intern Med. 1999;131:492-501. LinkGoogle Scholar4. Ezekowitz MD, Levine JA. Preventing stroke in patients with atrial fibrillation. JAMA. 1999;281:1830-5. CrossrefMedlineGoogle Scholar5. Antani MR, Beyth RJ, Covinsky KE, Anderson PA, Miller DG, Cebul RD, et al . Failure to prescribe warfarin to patients with nonrheumatic atrial fibrillation. J Gen Intern Med. 1996;11:713-20. CrossrefMedlineGoogle Scholar6. Laupacis A, Albers G, Dalen J, Dunn MI, Jacobson AK, Singer DE. Antithrombotic therapy in atrial fibrillation. Chest. 1998;114 5 Suppl 579S-589S. CrossrefMedlineGoogle Scholar7. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. JAMA. 1991; 265:3255-64. Google Scholar8. Massicotte P, Marzinotto V, Vegh P, Adams M, Andrew M. Home monitoring of warfarin therapy in children with a whole blood prothrombin time monitor. J Pediatr. 1995;127:389-94. CrossrefMedlineGoogle Scholar9. Kilander L, Andren B, Nyman H, Lind L, Boberg M, Lithell H. Atrial fibrillation is an independent determinant of low cognitive function: a cross-sectional study in elderly men. Stroke. 1998;29:1816-20. CrossrefMedlineGoogle Scholar10. Patients with nonvalvular atrial fibrillation at low risk of stroke during treatment with aspirin: Stroke Prevention in Atrial Fibrillation III Study. The SPAF III Writing Committee for the Stroke Prevention in Atrial Fibrillation Investigators. JAMA. 1998; 279:1273-7. Google Scholar11. Ezekowitz MD, James KE, Nazarian SM, Davenport J, Broderick JP, Gupta SR, et al . Silent cerebral infarction in patients with nonrheumatic atrial fibrillation. The Veterans Affairs Stroke Prevention in Nonrheumatic Atrial Fibrillation Investigators. Circulation. 1995;92:2178-82. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Michael D. Ezekowitz, MD, PhDAffiliations: Yale University School of Medicine; New Haven, CT 06510 (Ezekowitz)Note: Dr. Ezekowitz is a consultant for several companies, including DuPont, the manufacturer of Coumadin.Acknowledgment: The author thanks Paulette Trent for administrative support.Corresponding Author: Michael D. Ezekowitz, MD, PhD, Yale Clinical Trials Office, Yale University School of Medicine, 47 College Street, Suite 202, New Haven, CT 06510. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAntithrombotic Therapy To Prevent Stroke in Patients with Atrial Fibrillation Robert G. Hart , Oscar Benavente , Ruth McBride , and Lesly A. Pearce Metrics Cited byTO DETERMINE THE ROLE OF RANOLAZINE FOR RHYTHM CONTROL STRATEGY IN PATIENTS WITH NON- VALVULAR ATRIAL FIBRILLATION- AN OBSERVATIONAL STUDY FROM A TERTIARY CARE CENTER. 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