Atrial fibrillation in UK South Asian hospitalized ischemic stroke patients: The BRAINS study

Abstract

Introduction South Asian diaspora comprise one of the largest ethnic minority groups in the world yet data about atrial fibrillation (AF) in this demographic is understudied. Our aim is to identify differences in AF prevalence and treatment between South Asians and white British stroke patients. Method The UK arm of a prospective ongoing large international repository on stroke was analysed. Ethnic differences in AF prevalence and management in those with ischemic stroke were analysed. Results Of the 3515 individuals recruited with ischemic stroke, 1482 (men: 972, women: 510) were South Asian and 2033 (men:1141, women:892) of white British ethnicity. AF was present in 462 white British and 193 South Asians stroke patients, with South Asians displaying a lower prevalence of AF (South Asians: 13.0% vs white British 22.7%, P<0.001). Despite adjustment for traditional AF risk factors, South Asians had a significantly lower OR of AF compared to white British stroke patients (OR: 0.40, 95%CI: 0.33:0.49, P<0.001). Among confirmed AF cases, 31.8% of South Asians and 41.4% of white British were untreated at admission (P = 0.02). Antiplatelet treatment was significantly higher among South Asians at both admission (South Asian: 47.4% vs. white British: 29.9%, P<0.001) and discharge (South Asian: 49.5% vs. white British: 34.7%, P = 0.001), although anticoagulation treatment was similar across both ethnic groups at admission (South Asian: 28.5% vs white British: 28.1%, P = 0.93), and discharge (South Asian: 45.1% vs white British: 43.1%, P = 0.64). Conclusion Stroke patients of South Asian descent are at significantly lower risk of AF but more likely to be on antiplatelet treatment compared to their white British counterparts.

Risk Factors for Hypertension in Patients with Stroke Presenting to Tertiary Care Hospital

“…In diabetic patients, the prevalence of hemorrhagic stroke was signicantly outweighed by the ischemic stroke frequency. 18 Demographics of our study showed that nearly 42.2% of the patients suered from elevated blood pressure, with females taking the lead. The Medical Research Council and Thomson et al analysis also revealed a notable decrease in stroke in patients with wellmanaged hypertension.…”

Atrial fibrillation: comorbidities, lifestyle, and patient factors

“…Both ethnic groups have similar rates of oral anticoagulation prescribing on admission and discharge. 285 People of South Asian ethnicity eligible for the NHS Health Check, attend it more often than any other ethnic group, especially South Asian women. 286 This is likely to help mitigate the higher overall cardiovascular risk in the South Asian population.…”