Risk factors for thromboembolic stroke in elderly patients with chronic atrial fibrillation

Chronic atrial fibrillation (AF) in the presence or absence of rheumatic valvular heart disease is associated with an increased incidence of stroke. 1,2 We reported in a prospective study that at 27-month follow-up, echocardiographic left ventricular (LV) hypertrophy in elderly patients with systolic or diastolic hypertension was associated with an increased incidence of new atherothrombotic brain infarction. 3 We also demonstrated in a prospective study that at 3-year follow-up, risk factors for atherothrombotic brain infarction were cigarette smoking, systolic or diastolic hypertension and diabetes mellitus in elderly men and systolic or diastolic hypertension, diabetes mellitus and obesity in elderly women. 4 This report correlates in elderly patients with chronic AF the prevalence of thromboembolic (TE) stroke with the presence or absence of rheumatic mitral stenosis, mitral anular calcium, valvular aortic stenosis, systolic or diastolic hypertension, prior myocardial infarction, left atrial enlargement and LV hypertrophy.