Atrial fibrillation as a risk factor for stroke recurrence
Although atrial fibrillation is a well-known risk factor for ischemic stroke, the extent to which it increases the risk of stroke recurrence, particularly in elderly patients, is less certain. We performed a retrospective cohort study of 915 patients aged 50 to 94 years who were admitted with an isc...
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| Veröffentlicht in: | The American journal of medicine 2003-02, Vol.114 (3), p.206-210 |
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| creator | Penado, Susana Cano, Marta Acha, Olga Hernández, José L Riancho, José A |
| description | Although atrial fibrillation is a well-known risk factor for ischemic stroke, the extent to which it increases the risk of stroke recurrence, particularly in elderly patients, is less certain.
We performed a retrospective cohort study of 915 patients aged 50 to 94 years who were admitted with an ischemic stroke. The rates of recurrent strokes and recurrent severe strokes were estimated with the Kaplan-Meier method. The effects of atrial fibrillation on stroke risk were analyzed with proportional hazards models.
Of the 829 patients who survived the initial hospitalization, 163 (20%) had a stroke during follow-up. Of the 203 patients with atrial fibrillation during index hospitalization who were not anticoagulated, 54 (27%) had recurrent strokes, compared with 18% (19/103) among those with atrial fibrillation who were anticoagulated and 17% (90/523) among those without atrial fibrillation. The age-adjusted hazard ratio for recurrent stroke among those with atrial fibrillation who were not treated with anticoagulants was 2.1 (95% confidence interval [CI]: 1.4 to 2.9;
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| doi_str_mv | 10.1016/S0002-9343(02)01479-1 |
| format | Article |
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We performed a retrospective cohort study of 915 patients aged 50 to 94 years who were admitted with an ischemic stroke. The rates of recurrent strokes and recurrent severe strokes were estimated with the Kaplan-Meier method. The effects of atrial fibrillation on stroke risk were analyzed with proportional hazards models.
Of the 829 patients who survived the initial hospitalization, 163 (20%) had a stroke during follow-up. Of the 203 patients with atrial fibrillation during index hospitalization who were not anticoagulated, 54 (27%) had recurrent strokes, compared with 18% (19/103) among those with atrial fibrillation who were anticoagulated and 17% (90/523) among those without atrial fibrillation. The age-adjusted hazard ratio for recurrent stroke among those with atrial fibrillation who were not treated with anticoagulants was 2.1 (95% confidence interval [CI]: 1.4 to 2.9;
P <0.001), whereas the hazard ratio for recurrent severe stroke was 2.4 (95% CI: 1.6 to 3.6;
P <0.001). The increased risk was observed even in patients aged ≥80 years and persisted during the follow-up for more than 5 years.
Atrial fibrillation was an independent risk factor for stroke recurrence over a wide age range.</description><identifier>ISSN: 0002-9343</identifier><identifier>EISSN: 1555-7162</identifier><identifier>DOI: 10.1016/S0002-9343(02)01479-1</identifier><identifier>PMID: 12637135</identifier><identifier>CODEN: AJMEAZ</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Anticoagulants - therapeutic use ; Atrial Fibrillation - epidemiology ; Biological and medical sciences ; Cardiac arrhythmia ; Cardiac dysrhythmias ; Cardiology. Vascular system ; Cohort Studies ; Comorbidity ; Female ; Health risk assessment ; Heart ; Humans ; Incidence ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Neurology ; Recurrence ; Reference Values ; Retrospective Studies ; Risk Factors ; Spain - epidemiology ; Stroke ; Stroke - epidemiology ; Stroke - prevention & control ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>The American journal of medicine, 2003-02, Vol.114 (3), p.206-210</ispartof><rights>2003 Excerpta Medica Inc.</rights><rights>2003 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Feb 15, 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-15a2250e1e0a4d5032ab1984b39c812e6a2656b9d560e60f062bd49d92b33a4e3</citedby><cites>FETCH-LOGICAL-c470t-15a2250e1e0a4d5032ab1984b39c812e6a2656b9d560e60f062bd49d92b33a4e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0002-9343(02)01479-1$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14639745$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12637135$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Penado, Susana</creatorcontrib><creatorcontrib>Cano, Marta</creatorcontrib><creatorcontrib>Acha, Olga</creatorcontrib><creatorcontrib>Hernández, José L</creatorcontrib><creatorcontrib>Riancho, José A</creatorcontrib><title>Atrial fibrillation as a risk factor for stroke recurrence</title><title>The American journal of medicine</title><addtitle>Am J Med</addtitle><description>Although atrial fibrillation is a well-known risk factor for ischemic stroke, the extent to which it increases the risk of stroke recurrence, particularly in elderly patients, is less certain.
We performed a retrospective cohort study of 915 patients aged 50 to 94 years who were admitted with an ischemic stroke. The rates of recurrent strokes and recurrent severe strokes were estimated with the Kaplan-Meier method. The effects of atrial fibrillation on stroke risk were analyzed with proportional hazards models.
Of the 829 patients who survived the initial hospitalization, 163 (20%) had a stroke during follow-up. Of the 203 patients with atrial fibrillation during index hospitalization who were not anticoagulated, 54 (27%) had recurrent strokes, compared with 18% (19/103) among those with atrial fibrillation who were anticoagulated and 17% (90/523) among those without atrial fibrillation. The age-adjusted hazard ratio for recurrent stroke among those with atrial fibrillation who were not treated with anticoagulants was 2.1 (95% confidence interval [CI]: 1.4 to 2.9;
P <0.001), whereas the hazard ratio for recurrent severe stroke was 2.4 (95% CI: 1.6 to 3.6;
P <0.001). The increased risk was observed even in patients aged ≥80 years and persisted during the follow-up for more than 5 years.
Atrial fibrillation was an independent risk factor for stroke recurrence over a wide age range.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anticoagulants - therapeutic use</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Biological and medical sciences</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology. Vascular system</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Heart</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neurology</subject><subject>Recurrence</subject><subject>Reference Values</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Spain - epidemiology</subject><subject>Stroke</subject><subject>Stroke - epidemiology</subject><subject>Stroke - prevention & control</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1LxDAQhoMoun78BKUIih6qk88aL7KIXyB4UM8hTaeQtdtq0gr-e9PdRcGLh2EYeN7h5SFkn8IZBarOnwGA5ZoLfgLsFKgodE7XyIRKKfOCKrZOJj_IFtmOcZZO0FJtki3KFC8olxNyOe2Dt01W-zL4prG979rMxsxmwce3rLau70JWp4l96N4wC-iGELB1uEs2attE3FvtHfJ6e_NyfZ8_Pt09XE8fcycK6HMqLWMSkCJYUUngzJZUX4iSa3dBGSrLlFSlrqQCVFCDYmUldKVZybkVyHfI8fLve-g-Boy9mfvoMJVtsRuiKTgFpbhK4OEfcNYNoU3dDOOMcyEVTZBcQi50MQaszXvwcxu-DAUzmjULs2bUZtJemDVj7mD1fCjnWP2mVioTcLQCbHS2qYNtnY-_nFBcF2LkrpYcJmefHoOJzo8-K5_c9qbq_D9VvgFxOpJr</recordid><startdate>20030215</startdate><enddate>20030215</enddate><creator>Penado, Susana</creator><creator>Cano, Marta</creator><creator>Acha, Olga</creator><creator>Hernández, José L</creator><creator>Riancho, José A</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Sequoia S.A</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20030215</creationdate><title>Atrial fibrillation as a risk factor for stroke recurrence</title><author>Penado, Susana ; Cano, Marta ; Acha, Olga ; Hernández, José L ; Riancho, José A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-15a2250e1e0a4d5032ab1984b39c812e6a2656b9d560e60f062bd49d92b33a4e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anticoagulants - therapeutic use</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Biological and medical sciences</topic><topic>Cardiac arrhythmia</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiology. Vascular system</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Heart</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neurology</topic><topic>Recurrence</topic><topic>Reference Values</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Spain - epidemiology</topic><topic>Stroke</topic><topic>Stroke - epidemiology</topic><topic>Stroke - prevention & control</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Penado, Susana</creatorcontrib><creatorcontrib>Cano, Marta</creatorcontrib><creatorcontrib>Acha, Olga</creatorcontrib><creatorcontrib>Hernández, José L</creatorcontrib><creatorcontrib>Riancho, José A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Penado, Susana</au><au>Cano, Marta</au><au>Acha, Olga</au><au>Hernández, José L</au><au>Riancho, José A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Atrial fibrillation as a risk factor for stroke recurrence</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>2003-02-15</date><risdate>2003</risdate><volume>114</volume><issue>3</issue><spage>206</spage><epage>210</epage><pages>206-210</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><coden>AJMEAZ</coden><abstract>Although atrial fibrillation is a well-known risk factor for ischemic stroke, the extent to which it increases the risk of stroke recurrence, particularly in elderly patients, is less certain.
We performed a retrospective cohort study of 915 patients aged 50 to 94 years who were admitted with an ischemic stroke. The rates of recurrent strokes and recurrent severe strokes were estimated with the Kaplan-Meier method. The effects of atrial fibrillation on stroke risk were analyzed with proportional hazards models.
Of the 829 patients who survived the initial hospitalization, 163 (20%) had a stroke during follow-up. Of the 203 patients with atrial fibrillation during index hospitalization who were not anticoagulated, 54 (27%) had recurrent strokes, compared with 18% (19/103) among those with atrial fibrillation who were anticoagulated and 17% (90/523) among those without atrial fibrillation. The age-adjusted hazard ratio for recurrent stroke among those with atrial fibrillation who were not treated with anticoagulants was 2.1 (95% confidence interval [CI]: 1.4 to 2.9;
P <0.001), whereas the hazard ratio for recurrent severe stroke was 2.4 (95% CI: 1.6 to 3.6;
P <0.001). The increased risk was observed even in patients aged ≥80 years and persisted during the follow-up for more than 5 years.
Atrial fibrillation was an independent risk factor for stroke recurrence over a wide age range.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>12637135</pmid><doi>10.1016/S0002-9343(02)01479-1</doi><tpages>5</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Anticoagulants - therapeutic use Atrial Fibrillation - epidemiology Biological and medical sciences Cardiac arrhythmia Cardiac dysrhythmias Cardiology. Vascular system Cohort Studies Comorbidity Female Health risk assessment Heart Humans Incidence Male Medical sciences Middle Aged Multivariate Analysis Neurology Recurrence Reference Values Retrospective Studies Risk Factors Spain - epidemiology Stroke Stroke - epidemiology Stroke - prevention & control Vascular diseases and vascular malformations of the nervous system |
| title | Atrial fibrillation as a risk factor for stroke recurrence |
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