Screening for atrial fibrillation in the elderly

Any screening program in the community, while providing useful and previously unknown information, has the potential of uncovering findings of uncertain interpretation, especially regarding their impact on clinical outcomes, and therefore the justification of extending the screening to larger cohorts with substantial health care costs. As Shang and colleagues [1] remind us, the STROKESTOP study [2] detected a modest benefit from screening for atrial fibrillation (AF) on the primary combined endpoint of ischaemic or haemorrhagic stroke, systemic embolism, bleeding leading to hospitalisation and all-cause death (1.1% absolute reduction, or approximately 4% relative reduction) over a mean follow-up of 6.9  years, without a significant reduction in stroke alone in the intention-to-treat analysis; however, almost half of those who had been invited to the screening did not participate and were the ones with worse risk profile and higher calculated stroke risk, which may have diluted the significant be nefit of the screening program on incident stroke that was instead observed in the per-protocol analysis comparing participants with controls.
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Letter to the Editor Source Type: research