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Gender-Specific Differences for Risk of Disability and Death in Atrial Fibrillation-Related Stroke.

Ryan C Martin1, W Scott Burgin2, Matthew B Schabath3

  • 1Department of Cardiovascular Sciences, University of South Florida College of Medicine, Tampa, Florida.

The American Journal of Cardiology
|November 17, 2016
PubMed
Summary

Female gender and advanced age increase stroke severity in atrial fibrillation (AF) patients. This study found women with AF have a twofold higher risk of severe or fatal ischemic stroke, underscoring the need for effective anticoagulation.

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Area of Science:

  • Cardiology
  • Neurology
  • Public Health

Background:

  • Current atrial fibrillation (AF) guidelines use CHA 2 DS 2 -VASc for stroke risk, acknowledging female gender's impact on incidence.
  • Limited research exists on risk factors for increased stroke severity in AF patients.
  • Understanding stroke severity predictors is crucial for optimizing patient outcomes and treatment strategies.

Purpose of the Study:

  • To investigate patient characteristics associated with increased stroke severity in individuals with atrial fibrillation (AF).
  • To identify demographic and clinical factors predicting severe or fatal ischemic stroke in the AF population.
  • To inform stroke prevention and management strategies within the AF patient cohort.

Main Methods:

  • Retrospective analysis of 221 consecutive patients with AF and acute ischemic stroke from the Get With The Guidelines-Stroke database.
  • In-depth chart review to collect data on demographics, laboratory results, and comorbidities.
  • Modified Rankin Scale (mRS) at discharge used as a surrogate for stroke severity; severe stroke defined as mRS 4-6.

Main Results:

  • Female gender, advanced age, and decreased body surface area were associated with disabling or fatal stroke.
  • Logistic regression revealed significant odds ratios for female gender (OR 1.99) and age (OR 1.04) predicting severe stroke.
  • A history of coronary artery disease showed a borderline significant association with increased stroke severity (OR 1.89).

Conclusions:

  • Female gender is independently associated with a twofold increased risk of severe, disabling, or fatal ischemic stroke in patients with AF.
  • Advanced age also significantly contributes to stroke severity in this population.
  • These findings emphasize the importance of appropriate anticoagulation for stroke prophylaxis in AF patients, particularly women.