Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Screening strategies for atrial fibrillation in the elderly population: a systematic review and network meta-analysis
Session:
Posters (Sessão 6 - Écran 3) - Arrítmias 7 - Fibrilhação Auricular 2
Speaker:
Rafael Whitfield
Congress:
CPC 2022
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.3 Atrial Fibrillation - Diagnostic Methods
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Rafael Whitfield
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">Opportunistic screening is currently recommended for patients aged 65 years and older to detect atrial fibrillation (AF). However, this has recently been called into question by two studies that report that opportunistic screening is no more effective than usual care. Furthermore, there seems to be no consensus on the most effective screening strategy. Thus, we aimed to compare efficacy outcomes of different AF detection strategies using the methodology of systematic review with network meta-analysis.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">An electronic database search of MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE was performed. </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">We included randomised clinical trials (RCTs) or cluster RCTs that employed systematic or opportunistic screening in populations age ≥65 years against usual practice without AF screening. The outcome was the incidence of previously undiagnosed AF.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">The risk of bias of the included studies was assessed using Cochrane Risk of Bias Tool.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">We performed a random-effects pairwise meta-analysis and network meta-analysis within a frequentist framework R, for the outcome reported both in an intention to screen (ITS) analysis and in an as-screened (AS) analysis. We reported the results as relative risk (RR) with 95% confidence intervals (CI). We assessed the confidence in the evidence using the Grading of Recommendations Assessment, Development and Evaluation </span>(<span style="font-size:12.0pt">GRADE) framework.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">Ten studies were included, enrolling 94378 participants. Overall quality of evidence was low due to risk of bias. Pooled effect sizes from both network meta-analysis performed suggested that systematic screening was effective for detecting AF when compared with usual care (ITS: RR 2.12; 95% CI 1.41 to 3.16) (AS: RR 3.12; 95% CI 1.81 to 5.36) and opportunistic screening (ITS: RR 1.80; 95% CI 1.21 to 2.68) (AS: RR 2.18; 95% CI 1.31 to 3.63) but no significant difference was found between opportunistic screening and usual care (ITS: RR 1.18; 95% CI 0.82 to 1.69) (AS: RR 1.43; 95% CI 0.89 to 2.30).</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">Systematic screening was the most effective strategy for detecting AF in individuals aged 65 years or older without a known previous diagnosis. Opportunistic screening was no more effective than usual care, but the results were weakened by a low quality of evidence and imprecision in the results.</span></span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site