Int J Arrhythm.  2024 Sep;25(3):14. 10.1186/s42444-024-00120-x.

Atrial fibrillation fact sheet in Korea 2024: part 2—stroke prevention in Korean patients with atrial fibrillation

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
  • 2Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  • 3Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
  • 4Division of Cardiology, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
  • 5Division of Cardiology, Department of Internal Medicine, Seoul Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
  • 6Division of Cardiology, Department of Internal Medicine, Sahmyook Medical Center, Seoul, Republic of Korea
  • 7Division of Cardiology, Department of Internal Medicine, Busan Regional CardioCerebroVascular Center, Dong-A University Hospital, Busan, Republic of Korea
  • 8Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, 42 Jaebongro, Dong‑gu, Gwangju 61469, Republic of Korea

Abstract


Objective
Atrial fibrillation (AF) increases the risk of thromboembolic events, making oral anticoagulants (OACs) essential for high-risk patients. This fact sheet provides nationwide statistics on AF management for stroke prevention in Korea. We aimed to evaluate current anticoagulation treatment trends and strategies in Korea. Method The Korean national health claims database from the National Health Insurance Service was used. AF patients aged ≥ 18 years from 2013 to 2022 were included. OAC use, including warfarin and non-vitamin K antagonist OACs (NOACs), was tracked through prescription data. The rates of OAC use were calculated based on continued use, considering prescription dates and amounts. For patients with multiple encounters, the last encounter was used for analysis.
Results
During the study, 20.4% of strokes were accompanied by AF, with AF diagnosed within 6 months before or after the stroke. The number of patients diagnosed with AF after a stroke increased from 4893 in 2013 to 6978 in 2022. Among newly diagnosed AF patients requiring OACs, 51% were not prescribed OACs within 6 months. OAC treatment rates for high-risk AF patients increased from 44.6% in 2013 to 77.5% in 2022, with NOAC prescriptions rising significantly after 2015. Regional variations in OAC prescription rates were observed, with lower rates in suburban/rural areas than in urban regions (76.0% vs. 79.6%, p < 0.001).
Conclusions
Considerable strokes could have been prevented with earlier AF detection and OAC treatment through more intensive electrocardiogram screening.

Keyword

Atrial fibrillation; Anticoagulants; Stroke; Thromboembolism
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