Epidemiology of NVAF in India vs Global Trends, Pg15

Key Highlights:

• Non-valvular Atrial Fibrillation (NVAF) is the most common sustained arrhythmia globally, with prevalence projected to double by 2050.
• Global Atrial Fibrillation (AF) prevalence is 2-4% in adults, while India's reported prevalence is lower at 0.5-1%, likely due to underdiagnosis.
• Indian NVAF patients present nearly a decade earlier, often in their 50s and 60s, compared to Western populations.
• Major risk factors contributing to early onset in India include hypertension, diabetes, coronary artery disease, and untreated sleep apnea.
• India faces a significant treatment gap in NVAF, particularly in anticoagulation and the use of DOACs, leading to high stroke risk.

Detailed Insights:

• The global rise in AF is attributed to aging populations and improved survival from cardiovascular diseases.
• In developed regions, the decline of rheumatic valvular disease has made NVAF the predominant form of AF.
• India's lower reported AF prevalence is linked to limited screening infrastructure and underdiagnosis, especially in rural areas.
• Urbanization in India contributes to a clustering of risk factors, increasing the NVAF burden in metropolitan areas.
• The coexistence of residual rheumatic disease in India complicates the classification and management of AF cases.
• Public health strategies in India must focus on early screening, risk factor modification, and enhanced access to anticoagulation to mitigate future stroke burden.

Scientific/Technical Concepts Involved:

• Non-valvular Atrial Fibrillation (NVAF): An irregular and often rapid heart rate originating in the atria, not caused by heart valve issues.
• Arrhythmia: An irregular heartbeat, where the heart beats too quickly, too slowly, or with an irregular rhythm.
• Anticoagulation: The use of medications to prevent blood clot formation, crucial for reducing stroke risk in AF patients.
• DOACs (Direct Oral Anticoagulants): A class of anticoagulant drugs that directly inhibit specific clotting factors, offering an alternative to warfarin.