Association Between Atrial Fibrillation and the Risk of Cardiovascular Mortality Among Elderly Adults With Ischemic Stroke in Northeast China: A Community-Based Prospective Study

Abstract

BackgroundElderly people are susceptible to atrial fibrillation (AF) and ischemic stroke (IS); however, less information is known about the association between AF and the risk of cardiovascular disease (CVD) mortality in elderly population with IS. We aimed to investigate the features of AF among aged people with IS and to illustrate whether AF accounted for CVD mortality.MethodsAt baseline, 790 patients with IS were enrolled from the general northeast Chinese elderly population (>60 years) between September 2017 to March 2019. The prevalence, awareness, and treatment of AF in each age group were analyzed, as well as major-related cardiovascular risk factors. The population was followed until July 31, 2021, and information on CVD death was obtained.ResultsA total of 25 people had AF, and the prevalence of AF in the elderly population with IS was 3.2%. The AF prevalence grew along with age from 1% (60–64 years) to 4.3% (70–74 years) and 4.2% (≥75 years), which was higher in the urban residents than in the rural residents (5.7 vs. 2.2%, P = 0.014). The awareness and treatment rates of patients with AF were 80 and 8%. After a median follow-up period of 3.3 years, 58 subjects died due to CVD and 5 subjects were accompanied with AF (rate 70.6/1,000 person-years). Elderly IS patients with AF had a 3.65-fold increased risk of CVD death in the fully adjusted model when compared with non-AF participants.ConclusionThe AF prevalence increased with age among the elderly population with IS. Moreover, elderly patients with IS in northeast China with AF had a higher CVD mortality. Therefore, early screening and prompt management of AF in elderly population with IS in northeast China are required.

Improving risk prediction for death, stroke and bleeding in Asian patients with atrial fibrillation

“…1 Patients with AF have an increased risk of mortality, ischaemic stroke/systemic embolism (SSE). 2 Oral anticoagulation (OAC) is uniformly recommended in guidelines to reduce risk of ischaemic stroke and mortality in AF in patients with stroke risk factors. [3][4][5] With increasing OAC use, major bleeding is also common complication of patients with AF, which is of particular concern in Asia, given the higher bleeding rates in Asians compared to non-Asians on antithrombotic drugs.…”

“…The objectives of this study were (1) to develop predictive models for all-cause mortality, SSE and major bleeding for Asian patients with AF from the COhort of antithrombotic use and Optimal INR Level in patients with non-valvular Atrial Fibrillation in Thailand (COOL-AF) population; (2) to compare the predictive models from COOL-AF study with the GARFIELD Refitted models for all three outcomes, the CHA 2 DS 2 -VASc score for allcause mortality and SSE, and HAS-BLED score for major bleeding. 9) unwillingness to participate.…”

“…The prevalence increased during the past 20 years and is projected to be increased during the next 30 years, with associated greater healthcare costs 1 . Patients with AF have an increased risk of mortality, ischaemic stroke/systemic embolism (SSE) 2 . Oral anticoagulation (OAC) is uniformly recommended in guidelines to reduce risk of ischaemic stroke and mortality in AF in patients with stroke risk factors 3–5 .…”

Impact of Achieving Blood Pressure Targets and High Time in Therapeutic Range on Clinical Outcomes in Patients With Atrial Fibrillation Adherent to the Atrial Fibrillation Better Care Pathway: A Report From the COOL‐AF Registry

“…Nonvalvular atrial fibrillation (AF) is one of the leading causes of cardiovascular morbidity and mortality, 1 , 2 as well as hospitalizations and increasing health care costs. 3 A majority of patients with AF are at risk of ischemic stroke and, therefore, need oral anticoagulant (OAC) for stroke prevention.…”