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Atrial fibrillation, anticoagulation and vitamins for homocysteine

Published on March 18, 2015   34 min

A selection of talks on Clinical Practice

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0:00
Hello, I'm David Spence. I'm from the Robarts Research Institute at Western University in London, Canada, and I'll be talking about some new evidence and insights regarding atrial fibrillation, anticoagulants, and vitamins for homocysteine.
0:17
This slide shows a list of all the talks in the stroke series, and they're all available online.
0:25
My disclosures are listed on this slide. And there are no disclosures that are relevant to this talk, except in the second line, I have received honoraria from Bayer and Boehringer-Ingelheim and Pfizer.
0:40
So why is atrial fibrillation increasingly important now? It's because the population is aging, especially in developed countries. The top section of this slide shows the change in age distribution in the Canadian population with a huge increase in elderly people because of the arrival of the pig and the python, the big boom and the baby boomers. And stroke goes up very steeply with age, more so than myocardial infarction. It's also commoner in women than myocardial infarction, partly because women live longer.
1:12
So in the Framingham Study, at age 50, only 1.5% of stroke was attributable to atrial fibrillation, but by age 80 to 89, it was 23.5%. And we now recognize that it's really a higher proportion because a lot of intermittent atrial fibrillation was missed in the past.
1:32
So here's a projection of the expected number of adults with atrial fibrillation in the United States, going from 1995 to 2050. And it's more than a doubling expected in atrial fibrillation.

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Atrial fibrillation, anticoagulation and vitamins for homocysteine

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