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October 27, 2019EP EuropaceOpen Access

Temporal relations between atrial fibrillation and ischaemic stroke and their prognostic impact on mortality

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Key result

Subsequent diagnosis of atrial fibrillation after ischaemic stroke (HR 4.05; 95% CI 2.17-7.54) or ischaemic stroke after atrial fibrillation (HR 3.08; 95% CI 1.90-5.00) significantly increased mortality.

Why the study?

Limited evidence is available on the temporal relationship between AF and ischaemic stroke and their impact on mortality in the community.

Population

100 132 individuals across five prospective community cohorts of the BiomarCaRE project

Comparison

AF first vs ischaemic stroke first vs sole diagnosis of either condition

Design

Prospective multicenter community-based cohort study

Follow-up

Median 16.1 years

Authors

SCStephan CamenFOFrancisco OjedaTNTeemu Niiranen

Discussion

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Overview

Bidirectional AF-stroke diagnoses associate with higher mortality; leaves open whether intensified monitoring improves outcomes in observational cohorts.

Study Design

Type

Cohort (n=100,132)

Multicenter

Yes

Structured PICO

P
Population
100,132 individuals from five European community cohorts, median age 46.1 years, followed for a median of 16.1 years to assess the temporal relationship between atrial fibrillation, ischaemic stroke, and mortality.
O
Outcome
Overall mortalityhard clinical

Main Result

Hazard Ratio: 4.05 (95% CI 2.17–7.54)

p-value: p=< 0.001

The temporal relationship between atrial fibrillation and ischaemic stroke is bidirectional, and developing both conditions significantly increases mortality risk regardless of the sequence of onset.

Cite This Study

Camen et al. (2019) conducted a cohort in Atrial fibrillation and ischaemic stroke (n=100,132). Subsequent diagnosis of atrial fibrillation after ischaemic stroke vs. No subsequent diagnosis was evaluated on overall mortality (HR 4.05, 95% CI 2.17-7.54, p=< 0.001). Subsequent diagnosis of atrial fibrillation after ischaemic stroke (HR 4.05; 95% CI 2.17-7.54) or ischaemic stroke after atrial fibrillation (HR 3.08; 95% CI 1.90-5.00) significantly increased mortality.

synapsesocial.com/papers/6a20facdd5f1bc1ba597cec3https://doi.org/10.1093/europace/euz312
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Ischemic Stroke Temporally Associated With New-Onset Atrial Fibrillation: A Population-Based Registry-Linkage Study2023 · 14 citations
  2. 2The Temporal Relationship Between Atrial Fibrillation and Ischemic Stroke.2013 · 3 citations
  3. 3Is there a temporal relationship between atrial fibrillation and stroke? A review2024 · 5 citations
  4. 4Temporal order of atrial fibrillation and acute myocardial infarction and associated prognosis in the Danish Diet, Cancer and Health cohort2025 · 2 citations
  5. 5Stroke, Timing of Atrial Fibrillation Diagnosis, and Risk of Death2021 · 21 citations