Amélie Gabet1, Charles Guenancia2, Gauthier Duloquin3, Valérie Olié1, Yannick Béjot3,4. 1. Cardiovascular and Neurovascular Division, Department of Non-Communicable Diseases, Santé Publique France, Saint-Maurice, France (A.G., V.O.). 2. Department of Cardiology (C.G.), University Hospital of Dijon, France. 3. Department of Neurology (G.D., Y.B.), University Hospital of Dijon, France. 4. Dijon Stroke Registry, EA4184, University Hospital and Medical School of Dijon, University of Burgundy, France (Y.B.).
Abstract
Background and Purpose: Because of the aging population, an increase in the prevalence of atrial fibrillation (AF) is currently observed, thus leading to a rise in AF-related ischemic stroke (IS). We analyzed the current prevalence of AF among patients with IS, their characteristics, and temporal trends from 2006 to 2017 in the population-based Dijon Stroke Registry. Methods: We used data from the Dijon Stroke Registry, an ongoing population-based study that records all cases of acute stroke among residents of the city of Dijon. All patients with IS between 2006 and 2017 were included. Previous AF was defined if it was mentioned in the medical file before stroke and newly diagnosed AF if it was diagnosed during the diagnostic workup of patients with acute stroke. Results: During the period 2014 to 2017, among the 796 patients with IS recorded in the Dijon Stroke Registry, 239 (30.0%) had AF, of whom 79 (9.9% of total patients with IS) had newly diagnosed AF, and 98 (12.3%) had previous AF treated with oral anticoagulants. Patients with IS with AF had more disabilities and a higher initial severity according to the National Institutes of Health Stroke Scale compared with those without AF. The age-adjusted prevalence of AF in patients with IS increased between 2006 and 2017 (+9% per time period), with an important increase in men aged 65 to 74 years (+81%) and women aged ≥85 years (+24%), and a significant decrease in women aged 65 to 74 years (−39%). The use of oral anticoagulant treatment in previous AF patients increased between 2006 and 2009 and 2014 and 2017 (29.3% to 61.3%, P<0.0001). However, 37.5% of patients with previous AF and CHADS2 score ≥2 were not treated with OAC. Conclusions: The increase in AF prevalence in patients with IS could be related to a better diagnosis of this condition. The underuse of oral anticoagulation treatment was still observed.
Background and Purpose: Because of the aging population, an increase in the prevalence of atrial fibrillation (AF) is currently observed, thus leading to a rise in AF-related ischemic stroke (IS). We analyzed the current prevalence of AF among patients with IS, their characteristics, and temporal trends from 2006 to 2017 in the population-based Dijon Stroke Registry. Methods: We used data from the Dijon Stroke Registry, an ongoing population-based study that records all cases of acute stroke among residents of the city of Dijon. All patients with IS between 2006 and 2017 were included. Previous AF was defined if it was mentioned in the medical file before stroke and newly diagnosed AF if it was diagnosed during the diagnostic workup of patients with acute stroke. Results: During the period 2014 to 2017, among the 796 patients with IS recorded in the Dijon Stroke Registry, 239 (30.0%) had AF, of whom 79 (9.9% of total patients with IS) had newly diagnosed AF, and 98 (12.3%) had previous AF treated with oral anticoagulants. Patients with IS with AF had more disabilities and a higher initial severity according to the National Institutes of Health Stroke Scale compared with those without AF. The age-adjusted prevalence of AF in patients with IS increased between 2006 and 2017 (+9% per time period), with an important increase in men aged 65 to 74 years (+81%) and women aged ≥85 years (+24%), and a significant decrease in women aged 65 to 74 years (−39%). The use of oral anticoagulant treatment in previous AF patients increased between 2006 and 2009 and 2014 and 2017 (29.3% to 61.3%, P<0.0001). However, 37.5% of patients with previous AF and CHADS2 score ≥2 were not treated with OAC. Conclusions: The increase in AF prevalence in patients with IS could be related to a better diagnosis of this condition. The underuse of oral anticoagulation treatment was still observed.
Authors: Alexandros A Polymeris; Kosmas Macha; Maurizio Paciaroni; Duncan Wilson; Masatoshi Koga; Manuel Cappellari; Sabine Schaedelin; Annaelle Zietz; Nils Peters; David J Seiffge; David Haupenthal; Luise Gassmann; Gian Marco De Marchis; Ruihao Wang; Henrik Gensicke; Svenja Stoll; Sebastian Thilemann; Nikolaos S Avramiotis; Bruno Bonetti; Georgios Tsivgoulis; Gareth Ambler; Andrea Alberti; Sohei Yoshimura; Martin M Brown; Masayuki Shiozawa; Gregory Y H Lip; Michele Venti; Monica Acciarresi; Kanta Tanaka; Maria Giulia Mosconi; Masahito Takagi; Rolf H Jäger; Keith Muir; Manabu Inoue; Stefan Schwab; Leo H Bonati; Philippe A Lyrer; Kazunori Toyoda; Valeria Caso; David J Werring; Bernd Kallmünzer; Stefan T Engelter Journal: Ann Neurol Date: 2021-11-29 Impact factor: 11.274