Editorial
Identification and treatment of patients with atrial fibrillation in primary care
| The first 150 words of the full text of this article appear below. |
Atrial fibrillation is the most common cardiac arrhythmia. The principal significance of atrial fibrillation, both to patients and health care systems, is the fivefold increased risk of embolic stroke.1 Atrial fibrillation is associated with 15% of all strokes2 and with 36% of strokes in patients older than 80.
Renewed interest in atrial fibrillation has followed publication of
randomised controlled trials showing that anticoagulation is effective
in decreasing this risk of stroke.3-7 The effect size for
warfarin is huge with a 68% relative risk reduction for stroke in the
primary prevention trials, with annual stroke risk reduced from 4.5%
to 1.4% and number need to treated (NNT) for one year of
32.8 In secondary prevention the effect size is even
greater with a 66% relative risk reduction, annual risk reduction from
12% to 4%, and NNT for one year of only 12.9 The data on
aspirin are less impressive, with the
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