Non-permanent atrial fibrillation and oral anticoagulant therapy are related to survival during 10 years after first-ever ischemic stroke. / Baturova, Maria A.; Lindgren, Arne; Carlson, Jonas; Shubik, Yuri V.; Bertil Olsson, S.; Platonov, Pyotr G.
In: International Journal of Cardiology, Vol. 232, 01.04.2017, p. 134-139.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Non-permanent atrial fibrillation and oral anticoagulant therapy are related to survival during 10 years after first-ever ischemic stroke
AU - Baturova, Maria A.
AU - Lindgren, Arne
AU - Carlson, Jonas
AU - Shubik, Yuri V.
AU - Bertil Olsson, S.
AU - Platonov, Pyotr G.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Background Atrial fibrillation (AF) detection in ischemic stroke patients triggers initiation of oral anticoagulant therapy (OAC). However, little is known regarding whether the persistency of AF affects long-term prognosis after ischemic stroke. We aimed to assess the impact of AF types and OAC on the outcome during a 10-year follow-up (FU) after first-ever ischemic stroke. Material and methods The study sample comprised 336 first-ever ischemic stroke patients (median age 76, interquartile range 25–75% (IQR) 67–82 years, 136 female) included in the Lund Stroke Register (LSR) in 2001–2002. At baseline, 109 patients had either permanent (n = 44) or recurrent (n = 65) AF. OAC was assessed using the Lund University Hospital anticoagulation database. All-cause mortality was assessed via linkage with the Swedish Causes of Death Register. Results During FU, 200 patients died. AF independently predicted all-cause mortality (hazard ratio (HR) 1.52 95% CI 1.14–2.04, p = 0.005); the worst prognosis was observed for permanent AF (HR 1.86 95% CI 1.29–2.69, p = 0.001). Patients with recurrent AF receiving OAC had similar survival rates to patients without AF (HR 0.73 95% CI 0.38–1.39, p = 0.333), while prognosis was worst for patients with permanent AF without OAC (HR 2.28 95% CI 1.38–3.77, p = 0.001) and intermediate for patients with permanent AF on OAC (HR 1.57 95% CI 0.92–2.67, p = 0.099). Conclusion All-cause mortality was independently associated with AF and was the greatest in stroke patients with permanent AF. Patients with recurrent AF receiving OAC have the most favorable outcome, similar to those without AF and significantly better than OAC-treated patients with permanent AF.
AB - Background Atrial fibrillation (AF) detection in ischemic stroke patients triggers initiation of oral anticoagulant therapy (OAC). However, little is known regarding whether the persistency of AF affects long-term prognosis after ischemic stroke. We aimed to assess the impact of AF types and OAC on the outcome during a 10-year follow-up (FU) after first-ever ischemic stroke. Material and methods The study sample comprised 336 first-ever ischemic stroke patients (median age 76, interquartile range 25–75% (IQR) 67–82 years, 136 female) included in the Lund Stroke Register (LSR) in 2001–2002. At baseline, 109 patients had either permanent (n = 44) or recurrent (n = 65) AF. OAC was assessed using the Lund University Hospital anticoagulation database. All-cause mortality was assessed via linkage with the Swedish Causes of Death Register. Results During FU, 200 patients died. AF independently predicted all-cause mortality (hazard ratio (HR) 1.52 95% CI 1.14–2.04, p = 0.005); the worst prognosis was observed for permanent AF (HR 1.86 95% CI 1.29–2.69, p = 0.001). Patients with recurrent AF receiving OAC had similar survival rates to patients without AF (HR 0.73 95% CI 0.38–1.39, p = 0.333), while prognosis was worst for patients with permanent AF without OAC (HR 2.28 95% CI 1.38–3.77, p = 0.001) and intermediate for patients with permanent AF on OAC (HR 1.57 95% CI 0.92–2.67, p = 0.099). Conclusion All-cause mortality was independently associated with AF and was the greatest in stroke patients with permanent AF. Patients with recurrent AF receiving OAC have the most favorable outcome, similar to those without AF and significantly better than OAC-treated patients with permanent AF.
KW - All-cause mortality
KW - Atrial fibrillation
KW - Ischemic stroke
KW - Oral anticoagulant therapy
KW - Permanent AF
KW - Recurrent AF
UR - http://www.scopus.com/inward/record.url?scp=85010876971&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2017.01.040
DO - 10.1016/j.ijcard.2017.01.040
M3 - Article
C2 - 28132778
AN - SCOPUS:85010876971
VL - 232
SP - 134
EP - 139
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -
ID: 11806523