Original ArticleIncidence and Cost of Stroke and Hemorrhage in Patients Diagnosed with Atrial Fibrillation in France
Section snippets
Methods
This is a retrospective database cohort study of adult patients hospitalized for AF in France in 2008. From this index hospitalization date, data on medical history were extracted over the previous 2-year period (2006-2008) and events of interest (i.e., strokes, hemorrhages, and other cardiovascular events) were documented longitudinally over the subsequent 2-year period (2008-2010).
Patients
A total of 99,949 hospital stays with AF as the principal or related diagnosis were identified in France in 2008. These represented 84,603 patients who constituted the AF population. Of these, 61,582 (72.8%) fulfilled the eligibility criteria (age ≥18 years and CHADS2 score >0) and constituted the study population (Fig 1). This population was elderly (mean age, 75 years) and predominantly male (53% men). The mean CHADS2 score was 1.90 ± 0.99 (Table 1). The risk factors for stroke most
Discussion
This study presents real-world data on the epidemiology, hospital management care, and hospital costs related to stroke, hemorrhage, and other cardiovascular events over 2 years of follow-up from 2008 to 2010 in a population of 61,582 AF patients in France with ≥1 risk factor for stroke.
The incidence rates for stroke and hemorrhage in patients with AF documented in the PMSI databases can be compared with those observed in recent clinical trials of oral anticoagulants. Over the last 4years, 3
Acknowledgment
We thank Adam Doble (Foxymed SARL, Paris, France) for help with the preparation of this article.
Drs. Cotté and Gaudin are employees of Bristol-Myers Squibb, and Dr. Kachaner is an employee of Pfizer. Dr. Vainchtock is a partner with and Dr. Chaize an employee of HEVA Lyon, a Health Economics Consultancy, who received fees from Bristol-Myers Squibb and Pfizer for carrying out the data analysis. Dr. Durand-Zaleski has received consultancy fees from Bristol-Myers Squibb and Pfizer for her
References (36)
- et al.
Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: Population-based estimates
Am J Cardiol
(1998) - et al.
Epidemiology of atrial fibrillation in France: Extrapolation of international epidemiological data to France and analysis of French hospitalization data
Arch Cardiovasc Dis
(2011) - et al.
Death and disability from warfarin-associated intracranial and extracranial hemorrhages
Am J Med
(2007) - et al.
Antithrombotic therapy for atrial fibrillation: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
Chest
(2012) - et al.
Cost of care distribution in atrial fibrillation patients: The COCAF study
Am Heart J
(2004) - et al.
A cross-sectional assessment of atrial fibrillation management among French patients in primary care
Value in Health
(2012) - et al.
Characteristics and management of outpatients with history of or current atrial fibrillation: The observational French EPHA study
Arch Cardiovasc Dis
(2010) - et al.
Cost-effectiveness of rivaroxaban compared to warfarin for stroke prevention in atrial fibrillation
Am J Cardiol
(2012) - et al.
Prevalence of diagnosed atrial fibrillation in adults: National implications for rhythm management and stroke prevention: The AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study
JAMA
(2001) - et al.
Incidence and prevalence of atrial fibrillation: an analysis based on 8.3 million patients
Europace
(2013)
Impact of atrial fibrillation on the risk of death: The Framingham Heart Study
Circulation
An update on the prognosis of patients with atrial fibrillation
Circulation
ARISTOTLE RE-LYs on the ROCKET. What’s new in stroke prevention in patients with atrial fibrillation?
Cardiol J
Atrial fibrillation as an independent risk factor for stroke: The Framingham Study
Stroke
Contribution of atrial fibrillation to incidence and outcome of ischemic stroke: Results from a population-based study
Stroke
Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation. Analysis of pooled data from five randomized controlled trials
Arch Intern Med
Dabigatran versus warfarin in patients with atrial fibrillation
N Engl J Med
Apixaban versus warfarin in patients with atrial fibrillation
N Engl J Med
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Supported by Bristol-Myers Squibb and Pfizer, manufacturers of apixaban.