Retrospective investigation of hospitalised patients with atrial fibrillation in mainland China.

Objective: To evaluate the epidemiology and status of atrial fibrillation in China.

Methods: Retrospective analysis of hospital records of patients with a primary diagnosis of atrial fibrillation, discharged between January 1999 and December 2001.

Results: Data were analysed from 9297 patients (mean age 65.5 years) from 41 hospitals in mainland China. During the period studied, atrial fibrillation admissions (mean 7.9%) increased as a proportion of cardiovascular admissions. The distribution of atrial fibrillation increased with age. Causes and associated conditions were advanced age (58.1%), hypertension (40.3%), coronary heart disease (34.8%), heart failure (33.1%), rheumatic valvular disease (23.9%), idiopathic atrial fibrillation (7.4%), cardiomyopathy (5.4%) and diabetes (4.1%). Permanent atrial fibrillation accounted for almost half of the patients (49.5%), and paroxysmal and persistent atrial fibrillation the remainder (33.7% and 16.7%, respectively). Paroxysmal atrial fibrillation was treated mainly by rhythm control (56.4%). In 82.8% of patients with chronic atrial fibrillation, a rate-control strategy was used. The prevalence of stroke was 17.5%. In non-valvular atrial fibrillation, risk factors associated with stroke included advanced age, history of hypertension, coronary heart disease and type of atrial fibrillation. A total of 64.5% of patients received antithrombotic therapy, predominantly with antiplatelet agents. Patients managed with antiplatelet or anticoagulant drugs had a significantly lower stroke rate than those receiving neither treatment, but there was no significant difference between antiplatelet and anticoagulant agents.

Conclusion: Most of the atrial fibrillation-related epidemiological factors in this population were similar to those reported in other countries. Antiplatelet and anticoagulant treatment both reduced stroke rate significantly.