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Prevalence of Atrial Fibrillation and Association of Atrial Fibrillation with Prior and New Thromboembolic Stroke in Older Patients
Author(s) -
Aronow Wilbert S.,
Ahn Chul,
Gutstein Hal
Publication year - 1996
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1996.tb01436.x
Subject(s) - atrial fibrillation , medicine , stroke (engine) , sinus rhythm , cardiology , incidence (geometry) , prospective cohort study , mechanical engineering , physics , engineering , optics
OBJECTIVE : To correlate atrial fibrillation with the incidence of new thromboembolic (TE) stroke in older patients with and without prior TE stroke. DESIGN : In a prospective study of 2101 older patients, electrocardiograms showed that atrial fibrillation was present in 283 patients (13%). At 42‐month mean follow‐up, atrial fibrillation was associated with the incidence of new TE stroke in patients with and without prior TE stroke. SETTING : A large long‐term health care facility where 2101 older patients were studied. PATIENTS : The 2101 patients included 1451 women and 650 men, mean age 81 ± 8 years (range 60 to 103). MEASUREMENTS AND MAIN RESULTS : Atrial fibrillation was present in 283 of 2101 patients (13%). The mean age was 84 ± 7 years in patients with atrial fibrillation and 81 ± 8 years in patients with sinus rhythm ( P = .0001). The prevalence of atrial fibrillation was 5% in patients aged 60 to 70 years, 14% in patients aged 71 to 80 years, 13% in patients aged 81 to 90 years, and 22% in patients aged 91 to 103 years ( P < .0001). Mean follow‐up was 31 ± 18 months in patients with atrial fibrillation and 44 ± 27 months in patients with sinus rhythm ( P = .0001). Previous TE stroke occurred in 123 of 283 patients (43%) with atrial fibrillation and in 431 of 1818 patients (24%) with sinus rhythm ( P < .0001). New TE stroke occurred in 131 of 283 patients (46%) with atrial fibrillation and in 303 of 1818 patients (17%) with sinus rhythm ( P < .0001). The log‐rank test showed that patients with atrial fibrillation had a significantly higher probability of developing new TE stroke than those with sinus rhythm ( P < .0001). The multivariate Cox regression model showed that independent risk factors for new TE stroke were male sex (relative risk = 1.3), prior TE stroke (relative risk = 3.1), and atrial fibrillation (relative risk = 3.3). CONCLUSIONS : Atrial fibrillation, prior TE stroke, and male sex are independent risk factors for the development of new TE stroke in older patients.