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Atrial fibrillation as a risk factor for stroke recurrence
Susana Penado1, Marta Cano, Olga Acha
1Department of Internal Medicine, Hospital U. M. Valdecilla, University of Cantabria, Santander, Spain.
The American Journal of Medicine
|March 15, 2003
Summary
Atrial fibrillation significantly increases the risk of recurrent stroke, especially in elderly patients. Anticoagulant treatment appears to mitigate this heightened risk for stroke recurrence.
Area of Science:
- Neurology
- Cardiology
- Epidemiology
Background:
- Atrial fibrillation is a known risk factor for ischemic stroke.
- The impact of atrial fibrillation on stroke recurrence risk in elderly patients requires further clarification.
Purpose of the Study:
- To investigate the association between atrial fibrillation and the risk of recurrent stroke.
- To evaluate the effect of anticoagulation on stroke recurrence in patients with atrial fibrillation.
- To assess stroke recurrence risk in elderly patients with atrial fibrillation.
Main Methods:
- Retrospective cohort study of 915 patients (aged 50-94) admitted with ischemic stroke.
- Kaplan-Meier method to estimate rates of recurrent and severe recurrent strokes.
- Proportional hazards models to analyze the effects of atrial fibrillation on stroke risk.
Main Results:
- Among 829 survivors, 163 (20%) experienced recurrent strokes.
- Patients with atrial fibrillation not on anticoagulants had a 2.1-fold increased risk of recurrent stroke (HR 2.1; 95% CI: 1.4-2.9).
- This increased risk was observed in patients aged 80 years and older and persisted for over 5 years.
Conclusions:
- Atrial fibrillation is an independent risk factor for stroke recurrence across a broad age spectrum.
- Anticoagulation may reduce the risk of recurrent stroke in patients with atrial fibrillation.
- Elderly patients with atrial fibrillation face a significant risk of recurrent stroke.