1.4 times increase in atrial fibrillation-related ischemic stroke and TIA over 12years in a stroke center

      Highlights

      • Large sample size data from a prospective database
      • 1.4 times increase in AF-related ischemic stroke and TIA over 12 years
      • The increase was not explained by aging or the use of Holter monitoring.

      Abstract

      Background and Purpose

      Prevalence of atrial fibrillation (AF) has quadrupled in the past 50 years in the general population. However, there is uncertainty regarding prevalence of AF over time in ischemic stroke patients given the aging population and enhanced surveillance of AF. We aimed to explore the changing prevalence of AF as well as other risk factors, stroke subtypes, investigations and pre-stroke medications among ischemic stroke and transient ischemic attack (TIA) patients.

      Methods

      We performed a retrospective analysis of data from a prospective database of consecutive patients with acute ischemic stroke and TIA from 2004 to 2015. Trends in risk factors and other variables year by year were analyzed using logistic regression or median regression.

      Results

      Among 6275 patients (median age [interquartile range] 74 [62–82] years, 56% males), the prevalence of AF increased 1.4 times over 12 years (from 23.3% to 32.7%, P < 0.001). The increase in the prevalence of AF remained significant after adjustment for age and the use of Holter monitoring. There was also a significant increase in prevalence of hypertension (67.4% to 77.3%), structural heart disease (9.8% to 10.5%), and previous TIA (10.9% to 13.7%) and a significant decrease in prevalence of dyslipidemia (71.8% to 49.4%).

      Conclusions

      There was a 1.4 times increase in the prevalence of AF among consecutive ischemic stroke and TIA patients in the past 12 years in a hospital-based registry. More active screening of the general population for AF may be warranted in order to decrease the overall stroke burden.

      Keywords

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