Key result
Incident AF linked to ~4-fold higher risk of ischemic stroke.
Why the study?
AF-related strokes are projected to triple by 2060 and cause cognitive decline, prompting this study to describe the incidence of new AF and its association with stroke, cognitive decline, and mortality in high-risk individuals.
Does incident atrial fibrillation increase the risk of ischemic stroke in older adults at high baseline cardiovascular risk?
Cohort (n=40,297)
Yes
Does incident atrial fibrillation increase the risk of ischemic stroke in older adults at high baseline cardiovascular risk?
Odds Ratio: 4.03 (95% CI 3.43–4.74)
Absolute Event Rate: 11.1% vs 2.7%
Incident atrial fibrillation in older adults is associated with a markedly elevated risk of ischemic stroke, cognitive decline, and mortality, highlighting the importance of screening and early intervention.
Supports vigilance for stroke after new AF in high-risk elders; extends associations to primary care but leaves screening benefits unproven.
(1) Background: AF-related strokes will triple by 2060, are associated with an increased risk of cognitive decline, and alone or in combination, will be one of the main health and economic burdens on the European population. The main goal of this paper is to describe the incidence of new AF associated with stroke, cognitive decline and mortality among people at high risk for AF. (2) Methods: Multicenter, observational, retrospective, community-based studies were conducted from 1 January 2015 to 31 December 2021. The setting was primary care centers. A total of 40,297 people aged ≥65 years without previous AF or stroke were stratified by AFrisk at 5 years. The main measurements were the overall incidence density/1000 person-years (CI95%) of AF and stroke, prevalence of cognitive decline, and Kaplan–Meier curve. (3) Results: In total, 46.4% women, 77.65 ± 8.46 years old on average showed anAF incidence of 9.9/103/year (CI95% 9.5–10.3), associated with a four-fold higher risk of stroke (CI95% 3.4–4.7), cognitive impairment(OR 1.34 (CI95% 1.1–1.5)), and all-cause mortality (OR 1.14 (CI95% 1.0–1.2)), but there was no significant difference in ischemic heart disease, chronic kidney disease, or peripheral arteriopathy. Unknown AF was diagnosed in 9.4% and of these patients, 21.1% were diagnosed with new stroke. (4) Conclusions: The patients at high AF risk (Q4th) already had an increased cardiovascular risk before they were diagnosed with AF.
No takes yet. Share an insight, caveat, or question.
Clua‐Espuny et al. (2023) conducted a cohort in High risk for atrial fibrillation (n=40,297). Incident atrial fibrillation vs. No incident atrial fibrillation was evaluated on Ischemic stroke (OR 4.03, 95% CI 3.43-4.74). Incident atrial fibrillation was associated with a four-fold increased risk of ischemic stroke (OR 4.03) compared to patients who did not develop atrial fibrillation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: