BACKGROUND AND PURPOSE: With the changes in management of atrial fibrillation (AF) over time, it is possible that the time trends of post-AF stroke incidence and mortality have changed. We sought to determine whether the incidence and survival of ischemic stroke after AF diagnosis have improved. METHODS: We identified the Olmsted County, Minn, residents who developed first AF from 1980 to 2000 and followed them in medical records to 2004. The outcomes were first ischemic stroke and death. RESULTS: Of the 4117 subjects diagnosed with first AF and without previous stroke, 446 (11%) sustained a first ischemic stroke during a mean follow-up time of 5.5+/-5.0 years. The age- and sex-adjusted incidence of stroke decreased, on average, by 3.4% per year (P=0.0001), concurrent with an increase in warfarin and aspirin use (both P<0.0001) and reduction of systolic blood pressure (P<0.001). The age-adjusted ischemic stroke incidence was higher in women (P=0.039), but not after adjusting for systolic blood pressure (P=0.41). Compared with the general Minnesota white population, the relative mortality hazard ratio was 1.88 for men and 1.84 for women without stroke and 3.03 for men and 3.80 for women (P<0.05) with stroke. The relative mortality hazard did not vary by age or calendar year of AF diagnosis. CONCLUSIONS: Post-AF ischemic stroke incidence decreased significantly from 1980 to 2000, during which time a substantial increase in the use of antithrombotic therapy and reduction of systolic blood pressure was evident. The relative mortality risk of stroke, however, had not improved over time.
BACKGROUND AND PURPOSE: With the changes in management of atrial fibrillation (AF) over time, it is possible that the time trends of post-AF stroke incidence and mortality have changed. We sought to determine whether the incidence and survival of ischemic stroke after AF diagnosis have improved. METHODS: We identified the Olmsted County, Minn, residents who developed first AF from 1980 to 2000 and followed them in medical records to 2004. The outcomes were first ischemic stroke and death. RESULTS: Of the 4117 subjects diagnosed with first AF and without previous stroke, 446 (11%) sustained a first ischemic stroke during a mean follow-up time of 5.5+/-5.0 years. The age- and sex-adjusted incidence of stroke decreased, on average, by 3.4% per year (P=0.0001), concurrent with an increase in warfarin and aspirin use (both P<0.0001) and reduction of systolic blood pressure (P<0.001). The age-adjusted ischemic stroke incidence was higher in women (P=0.039), but not after adjusting for systolic blood pressure (P=0.41). Compared with the general Minnesota white population, the relative mortality hazard ratio was 1.88 for men and 1.84 for women without stroke and 3.03 for men and 3.80 for women (P<0.05) with stroke. The relative mortality hazard did not vary by age or calendar year of AF diagnosis. CONCLUSIONS: Post-AF ischemic stroke incidence decreased significantly from 1980 to 2000, during which time a substantial increase in the use of antithrombotic therapy and reduction of systolic blood pressure was evident. The relative mortality risk of stroke, however, had not improved over time.
Authors: Kevin G Graves; Victoria Jacobs; Heidi T May; Michael J Cutler; John D Day; T Jared Bunch Journal: Curr Treat Options Cardiovasc Med Date: 2018-01-24
Authors: Sven Möbius-Winkler; Marcus Sandri; Norman Mangner; Phillip Lurz; Ingo Dähnert; Gerhard Schuler Journal: J Vis Exp Date: 2012-02-28 Impact factor: 1.355
Authors: Ranjini R Roy; Sandeep Sagar; T Jared Bunch; Wahaj Aman; Daniel J Crusan; Komandoor Srivathsan; Samuel J Asirvatham; Win K Shen; Arshad Jahangir Journal: J Atr Fibrillation Date: 2013-08-31
Authors: Matthew L Flaherty; Opeolu Adeoye; Padmini Sekar; Mary Haverbusch; Charles J Moomaw; Haiyang Tao; Joseph P Broderick; Daniel Woo Journal: Stroke Date: 2009-03-12 Impact factor: 7.914
Authors: Marc L Schermerhorn; Kristina A Giles; Allen D Hamdan; Mark C Wyers; Frank B Pomposelli Journal: J Vasc Surg Date: 2009-04-16 Impact factor: 4.268
Authors: Aarti A Patel; Kristine Ogden; Mark Veerman; Samir H Mody; Winnie W Nelson; Nancy Neil Journal: Popul Health Manag Date: 2014-01-29 Impact factor: 2.459
Authors: Sebastian Straube; Martin R Tramèr; R Andrew Moore; Sheena Derry; Henry J McQuay Journal: BMC Gastroenterol Date: 2009-06-05 Impact factor: 3.067