Abstract
Background: Non-communicable diseases, the major cause of death and disability, are susceptible to modifiable and non-modifiable risk factors. Atrial fibrillation (AF) increases the risk of stroke by 4 to 5 times and can lead to cardiovascular mortality. This study was conducted to assess the effects of different sociodemographic and socioeconomic factors on stroke development in patients with AF. Methods: A cross-sectional study was conducted between January and June 2018 on patients recruited from Lebanese community pharmacies. The CHA 2DS 2-VASc scoring system is utilized as a stroke risk stratification tool in AF patients. Participants with a previous physician diagnosis of AF, documented on medical records, were included in this study. Data was collected through a survey that was distributed to all eligible patients. Results: A total of 524 patients were enrolled in the study with amean age (± SD) of 58.75± 13.59 years with hypertension (78.4%) being the most predominant disease. The results showed that obesity (Beta=0.61, p-value =0.011), retirement and unemployment compared to employment (Beta=1.44 and 1.44, p-value=0.001 respectively), divorced/widow compared to married (Beta=1.38, p-value =0.001) were significantly associated with higher CHA 2DS 2-VASc scores whereas high versus low socio-economic status (Beta=-1.03, p=0.009) and high school education versus primary education level (Beta=-0.49, p-value=0.025) were significantly associated with lower CHA 2DS 2-VASc scores. Conclusions: The study highlights that the CHA 2DS 2-VASc score is affected by the presence of various sociodemographic and socioeconomic characteristics in patients with AF. Thus, screening for those factors may predict the progression of cardiovascular disease and may provide an optimal intervention.
Highlights
Non-communicable diseases (NCDs), known as chronic diseases, are responsible for the premature death of 41 million people globally, accounting for 71% of all deaths annually.1 According to the World Health Organization (WHO), coronary heart disease and stroke are the world’s biggest killers in 2016, accounting for 15.2 million deaths worldwide.1 The global crude death rate per 100,000 population of high-income, upper and lower-middle-income countries due to stroke is the second-highest following coronary heart disease.2,3 In Lebanon, Noncommunicable Diseases (NCD) are the major cause of death and disability and are expected to be responsible for 91% of deaths by 2025.4NCDs are susceptible to modifiable and non-modifiable risk factors that are known to trigger their development
The study highlights that the CHA2DS2-VASc score is affected by the presence of various sociodemographic and socioeconomic characteristics in patients with Atrial fibrillation (AF)
Lack of diagnosis by an AF physician is a potential factor for non-enrollment
Summary
NCDs are susceptible to modifiable and non-modifiable risk factors that are known to trigger their development. Other factors cannot be altered to modify disease development as age, gender, and previous medical conditions. Page 4: Ethics approval and consent to participate:. Non-communicable diseases, the major cause of death and disability, are susceptible to modifiable and non-modifiable risk factors. This study was conducted to assess the effects of different sociodemographic and socioeconomic factors on stroke development in patients with AF. The CHA2DS2-VASc scoring system is utilized as a stroke risk stratification tool in AF patients. Results: A total of 524 patients were enrolled in the study with a mean age (± SD) of 58.75 ± 13.59 years with hypertension (78.4%) being the most predominant disease. The results showed that obesity (Beta=0.61, p-value =0.011), retirement and unemployment compared to employment (Beta=1.44 and 1.44, p-value=0.001 respectively), divorced/widow compared to married (Beta=1.38, p-value =0.001) were significantly associated with higher CHA2DS2-VASc scores version 2 (revision)
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