Skip navigation links
Open menu
 
  CommunicationNewsAtrial Fibrillation in Italy: prevention as a challenge

News

Atrial Fibrillation in Italy: prevention as a challenge

A study by the University of Florence and the CNR-IN published on Europace

Atrial fibrillation is the most frequent cardiac arrhythmia of clinical relevance and has a close correlation with advanced age. Its importance is linked to the fact that it increases by five times the risk of stroke, the second cause of death and the first cause of disability in the adult-elderly subjects. From this background the “FAI: Atrial Fibrillation in Italy" Project was developed by the Institute of Neuroscienceof the National Research Council (CNR-IN) and the University of Florence. The research was funded by the Italian Ministry of Health, in collaboration with the Regione Toscana.

“Currently in Italy about 200,000 strokes occur every year, with a cost for the National Health Service exceeding 4 billion euros”, explain the scientific coordinator Antonio Di Carlo (Cnr-IN) and the scientific director Domenico Inzitari (University of Florence - Neurofarba Department). “More than a quarter are attributable to this arrhythmia, that can cause the formation of clots inside the heart, able to reach the brain causing a stroke that is then called cardioembolic. Compared to strokes due to different causes, those of cardioembolic origin have a more devastating impact in terms of residual disability and survival.”

The research data, published in the journal Europace, official organ of the European Society of Cardiology and of the European Heart Rhythm Association [“Prevalence of atrial fibrillation in the elderly and projections from 2020 to 2060 for Italy and the European Union: the FAI Project "Doi: 10.1093 / europace / euz141], estimated, for the first time in Italy, the frequency of atrial fibrillation in a representative sample of the elderly population, including  6,000 over-65s enrolled among those assisted by general practitioners (GPs) in three operational units located in Lombardy, Tuscany and Calabria. All participants underwent a screening procedure and subsequent clinical confirmation. The study also aimed  to develop and validate a methodology directly transferable to GPs and the National Health Service. Italy is one of the oldest countries in the world with a percentage of over-65s that exceeds 21%, therefore age-related diseases are of great relevance for the National Health Service and their impact will increase with aging of the population.

“The data collected indicate a 8.1% atrial fibrillation frequency in the elderly population of our country,” noted Antonio Di Carlo. “This means that one out of 12 elders is affected, leading to an estimated 1.1 million people suffering from this arrhythmia in Italy. The study also allowed us to demonstrate that, due to the demographic changes, these numbers will be constantly growing over the next few decades, reaching 1.9 million cases in 2060.”

The elderly subjects suffering from atrial fibrillation are a particularly fragile population group, often with difficulty in accessing services and care. “Considering that older patients with atrial fibrillation are those most at risk of comorbidity and complications, the weight of this arrhythmia is expected to grow enormously in the coming decades, with a predictable increase in cardioembolic strokes, of greater severity, posing important challenges, linked to prevention and treatment,” argue Di Carlo and Inzitari. “To this purpose, effective therapies are currently available, such as anticoagulants, which reduce the risk of stroke in these patients by about ⅔, but are still far from an optimal use.”

Adequate screening campaigns, with the direct involvement of GPs, could allow an early identification of atrial fibrillation, through a simple evaluation of the pulse and subsequent execution of an electrocardiogram in subjects in which it appears to be irregular, in order to reduce the huge social and health costs associated with this arrhythmia and its consequences.

Using the demographic projections provided by the European Statistical Office (Eurostat), the research has also made possible to estimate the cases of atrial fibrillation expected in the elderly population of the 28 countries of the European Union. The prevalent cases in 2016 were 7.6 million, projected  to almost double up to 14.4 million in 2060. In 2016 in Italy the over-80s suffering from atrial fibrillation represented 53% of cases;, due to demographic trends, in 2060 they will represent the 69% of the total. In Europe, fugures will increase from 51% to 65%.

“In light of the considerations of the FAI Project,” Inzitari concludes, “early diagnosis, adequate treatment plans and adherence to therapy continue to be the most suitable tools to tackle the pathology that has as protagonists, in a relationship of mutual reciprocity, patients and their GPs.”

Publication
date
10 July 2019
social share Facebook logo Twitter logo
social share Facebook logo Twitter logo