“Racial and Ethnic Disparities in Stroke Prevention for Atrial Fibrillation” was originally published in the March 2023 issue of The American Journal of Medicine.
Abstract
Racial and ethnic disparities in health care are well documented, although often underappreciated. In the setting of atrial fibrillation, stroke risk and severity may be higher in underrepresented ethnic populations. Additionally, the risk of bleeding is not uniform, and pharmacogenetics play an important role in anticoagulant therapy. In this narrative review, we discuss the complex issues surrounding stroke prevention in underrepresented ethnic groups with atrial fibrillation.
Clinical Significance
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Certain racial populations have a higher burden of cardiovascular risk factors, but a paradoxically lower incidence of atrial fibrillation. This is known as the “AF Racial Paradox”.
- Stroke risk and severity—and bleeding risk—are higher in some underrepresented ethnic populations. The CHA2DS2VASC score remains useful for stroke prediction across a diverse spectrum of patients.
- The ‘Atrial fibrillation Better Care (ABC) pathway’ for management of AF is useful in all populations.
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