Yihong Sun1, Dayi Hu, Kuibao Li, Ziqiang Zhou. 1. Cardiology Department of People's Hospital, Peking University, Beijing 100044, China. yihongs72@hotmail.com
Abstract
BACKGROUND: Data on stroke risk factor profiles and atrial fibrillation (AF) for the Chinese population are sparse. This study identified risk factors for stroke among native Chinese with nonrheumatic AF. METHODS: In this retrospective investigation, patients diagnosed with nonrheumatic AF were identified from 18 hospitals in representative areas of the country, from January 2000 to April 2002, based on the medical records. All parameters relevant to AF were compared between AF patients with stroke and those without. The independent risk factors for stroke were assessed with a logistic regression analysis. RESULTS: Patients numbering 3,425 with AF were included, among whom 827 subjects were discharged on account of stroke. The prevalence of stroke in nonrheumatic AF patients was 24.15%. AF patients with stroke were significantly older than controls (73.31 +/- 9.18 versus 68.22 +/- 12.29 y, p < 0.001) and more likely to have a history of hypertension (71.0 versus 51.6%, p < 0.001) and diabetes (17.9 versus 11.1%, p = 0.001).Both, systolic and diastolic blood pressure, are significantly higher in patients with stroke. Of all the parameters of echocardiography, there was strong evidence that left atrial (LA) thrombi significantly increased risk of stroke. Patients with persistent AF were more likely to have stroke than paroxysmal AF patients, while lone AF is less in patients with stroke than in those without. The rate of anticoagulation treatment is only 9.27%, but there were no significant differences between the 2 groups. In multivariate analysis, age > or = 75 y (odds ratio [OR] 1.76; 95% confidence interval [CI] 1.08-2.98), history of hypertension (OR 1.52; 95% CI 1.28-1.80), diabetes (OR 1.39; 95% CI 1.11-1.76), high systolic blood pressure (OR 1.71; 95% CI 1.21-2.28), LA thrombi (OR 2.77; 95% CI 1.25-6.13) were independent predictors for stroke. CONCLUSIONS: The prevalence of stroke in hospitalized nonrheumatic AF patients was high. The population-specific risk factors for stroke were age > or = 75 y, diabetes, history of hypertension, high systolic blood pressure and LA thrombi by transesophageal echocardiography (TEE). These merit further evaluation.
BACKGROUND: Data on stroke risk factor profiles and atrial fibrillation (AF) for the Chinese population are sparse. This study identified risk factors for stroke among native Chinese with nonrheumatic AF. METHODS: In this retrospective investigation, patients diagnosed with nonrheumatic AF were identified from 18 hospitals in representative areas of the country, from January 2000 to April 2002, based on the medical records. All parameters relevant to AF were compared between AFpatients with stroke and those without. The independent risk factors for stroke were assessed with a logistic regression analysis. RESULTS:Patients numbering 3,425 with AF were included, among whom 827 subjects were discharged on account of stroke. The prevalence of stroke in nonrheumatic AFpatients was 24.15%. AFpatients with stroke were significantly older than controls (73.31 +/- 9.18 versus 68.22 +/- 12.29 y, p < 0.001) and more likely to have a history of hypertension (71.0 versus 51.6%, p < 0.001) and diabetes (17.9 versus 11.1%, p = 0.001).Both, systolic and diastolic blood pressure, are significantly higher in patients with stroke. Of all the parameters of echocardiography, there was strong evidence that left atrial (LA) thrombi significantly increased risk of stroke. Patients with persistent AF were more likely to have stroke than paroxysmal AFpatients, while lone AF is less in patients with stroke than in those without. The rate of anticoagulation treatment is only 9.27%, but there were no significant differences between the 2 groups. In multivariate analysis, age > or = 75 y (odds ratio [OR] 1.76; 95% confidence interval [CI] 1.08-2.98), history of hypertension (OR 1.52; 95% CI 1.28-1.80), diabetes (OR 1.39; 95% CI 1.11-1.76), high systolic blood pressure (OR 1.71; 95% CI 1.21-2.28), LA thrombi (OR 2.77; 95% CI 1.25-6.13) were independent predictors for stroke. CONCLUSIONS: The prevalence of stroke in hospitalized nonrheumatic AFpatients was high. The population-specific risk factors for stroke were age > or = 75 y, diabetes, history of hypertension, high systolic blood pressure and LA thrombi by transesophageal echocardiography (TEE). These merit further evaluation.
Authors: D G Wyse; A L Waldo; J P DiMarco; M J Domanski; Y Rosenberg; E B Schron; J C Kellen; H L Greene; M C Mickel; J E Dalquist; S D Corley Journal: N Engl J Med Date: 2002-12-05 Impact factor: 91.245
Authors: Robby Nieuwlaat; Alessandro Capucci; A John Camm; S Bertil Olsson; Dietrich Andresen; D Wyn Davies; Stuart Cobbe; Günter Breithardt; Jean-Yves Le Heuzey; Martin H Prins; Samuel Lévy; Harry J G M Crijns Journal: Eur Heart J Date: 2005-10-04 Impact factor: 29.983
Authors: A S Go; E M Hylek; K A Phillips; L H Borowsky; L E Henault; Y Chang; J V Selby; D E Singer Journal: Circulation Date: 2000-07-04 Impact factor: 29.690
Authors: Bi Huang; Yanmin Yang; Jun Zhu; Yan Liang; Han Zhang; Li Tian; Xinghui Shao; Juan Wang Journal: Yonsei Med J Date: 2015-01 Impact factor: 2.759
Authors: Yongchen Hao; Jing Liu; Sidney C Smith; Yong Huo; Gregg C Fonarow; Junbo Ge; Jun Liu; Kathryn A Taubert; Louise Morgan; Yang Guo; Mengge Zhou; Dong Zhao; Changsheng Ma Journal: BMJ Open Date: 2018-07-05 Impact factor: 2.692
Authors: Yun Gi Kim; Jong-Il Choi; Ki Yung Boo; Do Young Kim; Yeji Hong; Min Sun Kim; Kwang-No Lee; Jaemin Shim; Jin Seok Kim; Young-Hoon Kim Journal: Clin Cardiol Date: 2019-11-15 Impact factor: 2.882