In patients with atrial fibrillation and non-valvular heart disease surviving an initial stroke, the risk of recurrent cerebral ischemia was approximately 20% per year without anticoagulation.
Cohort (n=140)
What is the risk of recurrent stroke in patients with atrial fibrillation and non-valvular heart disease who do not receive anticoagulant therapy?
Patients with AF and non-valvular heart disease who survive an initial cerebral infarct face a high recurrent stroke risk of approximately 20% per year without anticoagulation.
One-hundred-forty patients with atrial fibrillation (AF) due to non-rheumatic, non-valvular heart disease (NVHD) who suffered a cerebral infarct were identified. Fifty-three (38%) died of the initial stroke. The surviving patients were followed up to 9 years without anticoagulant therapy. In the 59 patients available for follow-up, the risk of recurrent cerebral ischemia remained at approximately 20% per year throughout the 9 year observation period. The recurrence rate was the same regardless of age, sex, previous myocardial infarction, or whether chronic AF or intermittent AF were present. Only 7 (12%) died from a second stroke, however. The high annual rate of recurrence and lack of controlled therapeutic trials in this population of patients warrant a prospective study to define the benefits and relative risks of anticoagulant therapy in AF due to NVHD.
Sage et al. (1983) conducted a cohort in Atrial fibrillation and non-valvular heart disease (n=140). No anticoagulant therapy was evaluated on Recurrent cerebral ischemia. In patients with atrial fibrillation and non-valvular heart disease surviving an initial stroke, the risk of recurrent cerebral ischemia was approximately 20% per year without anticoagulation.