Stroke prevention in atrial fibrillation (AF)
Atrial fibrillation (AF) is a type of arrhythmia often seen in elderly people and there are approximately 800,000 patients in Japan.1)
People with AF are approximately five times more likely to suffer brain infarction (stroke due to blocked blood vessel in the brain).2) AF patients who experience brain attack also have a high mortality rate, and have a high probability of experiencing severe sequelae requiring nursing care and becoming bedridden.3) As a result, not only the burden of the patients and their caretakers, but also the socio-economic burden of the society become extremely heavy.
When treated appropriately with anti-coagulants, approximately 60% or more of strokes caused by AF can be prevented.4) Therefore, it is of extreme significance that AF is detected early and treated appropriately with anti-coagulant drug (i.e. the appropriate medicine at the appropriate dosage).
However, early detection of AF is not easy. Since AF’s symptoms and the relation to developing stroke are not well known, most people do not check pulse, do not suspect AF when they feel irregular pulse, or do not seek consultations even if they suspect AF. In addition, when AF is asymptomatic or transient (i.e. symptoms disappear shortly after presentation), its detection is even more difficult.
It is also pointed out that the current state of anti-coagulant therapy is insufficient. Only about a half of AF patients are reported to be receiving appropriate anti-coagulant therapy.5)
Given this background, the Japan Stroke Association and Bayer Yakuhin, Ltd. have come together for a joint project: “Take Action for StroKe prevention in AF (TASK-AF)”.
The project aims to promote effective stroke prevention through early AF detection and appropriate treatment with the collaboration of local governments, insurers, and healthcare providers.
The project committee has issued a proposal entitled “A Proposal for Stroke Prevention: Conquering Cardiogenic Cerebral Embolism” outlining specific activities supporting this aim.
Through the implementation of the proposed model projects followed by the evaluation and dissemination of its effects, it is expected that the proposal be realized nationwide leading to more effective stroke prevention in Japan.
“TASK AF: Take Action for StroKe prevention in AF”
Project Committee Chairman
Takenori Yamaguchi
- ＜References＞
- 1) Inoue H, et al. Int J Cardiol 2009; 137: 102-107
- 2) Wolf PA, et al. Stroke 1991; 22: 983-988
- 3) Okumura K, et al. Jpn J Electrocardiol 2011;31:292-296
- 4) EAFT （European Atrial Fibrillation Trial） Study Group. Lancet 1993；342：1255-1262
- 5) Akao M, et al. J Cardiol 2013; 61: 260
About “TASK AF: Take Action for StroKe prevention in AF”
This project aims to lessen stroke-related burden of the patients and caregivers and the socio-economic burden of the society by elucidation of the current situation and problems of stroke prevention in AF patients, and by promoting effective collaboration of local governments, insurers, and healthcare providers.
This project plans to raise awareness of the risk of stroke in AF and the significance of appropriate and continued anticoagulant therapy through the collaborative efforts of local governments, insurers, and healthcare providers. Consequently we strive for the changes in mindset/behavior of the persons concerned leading to the following goals:
① Early detection of AF
② Administration and continuance of appropriate anticoagulant therapy for AF
- ① Proposal concerning the public education of the significance of stroke prevention in AF patients and the measures that should be taken by local governments, insurers, and healthcare providers.
- ② Advancement of the pilot projects for developing an infrastructure which provides appropriate stroke prevention in AF patients in local governments in collaboration with parties concerned in the region following the above mentioned proposal.
- ③ Assessment of the pilot projects, and enlightenment of the parties concerned across the country through the dissemination of its results to promote a nation-wide roll-out of “Action for the prevention of stroke in AF”.
Recommendations and diagnosis / treatment flow for patients with atrial fibrillation(AF)
