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Association between Stroke History and Clinical Events in Atrial Fibrillation Patients after Valve Replacement

Xinsheng Yan1,2, Shuwen Lian3, Dong Wang1

  • 1Department of Clinical Laboratory, Wuhan Asia General Hospital Affiliated to Wuhan University of Science and Technology, 430056 Wuhan, Hubei, China.

Reviews in Cardiovascular Medicine
|May 12, 2025
PubMed

Insights

A history of stroke significantly increases adverse events, including thrombotic events and mortality, in patients with atrial fibrillation (AF) and valvular heart disease (VHD) after valve replacement surgery. This highlights stroke history as a critical risk factor.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Epidemiology

Background:

  • Atrial fibrillation (AF) and valvular heart disease (VHD) are common, often co-occurring conditions.
  • The impact of a prior stroke on clinical outcomes after valve replacement surgery in AF patients is not well-defined.

Purpose of the Study:

  • To investigate the association between a history of stroke and subsequent clinical events in patients with AF undergoing valve replacement.
  • To identify if stroke history is an independent risk factor for adverse outcomes post-surgery.

Main Methods:

  • Retrospective cohort study of 746 patients with AF who underwent valve replacement (2018-2019).
  • Patients were stratified by stroke history and followed for up to 24 months.
  • Endpoint events included thrombotic events, bleeding, and all-cause mortality; Cox regression analysis was used.

Main Results:

  • Patients with a stroke history experienced significantly more total adverse events (HR=2.08), thrombotic events (HR=10.28), and all-cause mortality (HR=5.74).
  • Bleeding events were not significantly different between groups (HR=0.87).
  • Stroke history was identified as an independent risk factor for adverse events, thrombotic events, and mortality.

Conclusions:

  • A prior stroke is a significant predictor of adverse clinical events in patients with AF following valve replacement.
  • These findings underscore the importance of considering stroke history in risk stratification and management strategies for these patients.
Abstract

Keywords:
atrial fibrillationhistory of strokemitral valve replacementprognosisvalvular heart disease

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