Atrial flutter and the risk of thromboembolism: A systematic review and meta-analysis

Ghali, William A.; Wasil, B.I.; Brant, Rollin; Exner, Derek V.; Cornuz, Jacques

doi:10.1016/j.amjmed.2004.06.048

Cited by 79 publications

(38 citation statements)

References 25 publications

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“…However, the epidemiology of atrial fl utter resembles very much the epidemiology of atrial fi brillation [26][27][28] , and most patients with atrial fl utter will eventually develop atrial fibrillation [27] .…”

Section: Discussionmentioning

confidence: 99%

Trends in Risk of Stroke in Patients with a Hospital Diagnosis of Nonvalvular Atrial Fibrillation: National Cohort Study in Denmark, 1980–2002

Frost

Andersen²,

Vestergaard³

et al. 2006

Neuroepidemiology

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Aim: We examined trends in incidence of stroke of any nature (ischemic and/or hemorrhagic) in subjects with a hospital diagnosis of nonvalvular atrial fibrillation or flutter in Denmark from 1980 to 2002 by sex, age and conditions of comorbidity. Methods: We identified all individuals, aged 40–89 years, with an incident hospital diagnosis of atrial fibrillation or flutter and no history of stroke or heart valve disease in the Danish National Registry of Patients, and subjects were followed in the Danish National Registry of Patients for occurrence of an incident diagnosis of stroke of any nature (ischemic and/or hemorrhagic) and in the Danish Civil Registration System (emigration and vital status). We used multivariate Cox proportional hazard regression analysis to estimate trends in incidence of stroke. Results: Nonvalvular atrial fibrillation or flutter was diagnosed in 141,493 subjects (75,126 men and 66,367 women), and during follow-up 15,964 subjects had an incident diagnosis of stroke. The hazard ratios for stroke in the last 3-year period compared to the first 5-year period, adjusted for 10-year age group, conditions of comorbidity, and general stroke trend in the Danish population were 0.78 (95% CI 0.70–0.86) in men, and 0.80 (95% CI 0.72–0.88) in women. The reduction in risk of stroke by calendar year was most prominent in patients aged 40–74 years. Conclusion: We observed a modest decrease in risk of stroke in subject with atrial fibrillation in Denmark during calendar years 1980–2002. However, we could not control for any changes in diagnostic performance, admission practice, and medical management of patients with atrial fibrillation.

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Section: Discussionmentioning

confidence: 99%

Trends in Risk of Stroke in Patients with a Hospital Diagnosis of Nonvalvular Atrial Fibrillation: National Cohort Study in Denmark, 1980–2002

Frost

Andersen²,

Vestergaard³

et al. 2006

Neuroepidemiology

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“…Our definition of AF therefore includes atrial flutter, but these 2 arrhythmias are closely related, often appear in the same patients, and have a similar stroke risk. 14,15 We also used the national register on all prescribed and dispensed drugs. This register covers all purchases of prescribed drugs nationwide and lists information about, for example, date of purchase, dispensed drug, quantity, and dosing instructions.…”

Section: Registriesmentioning

confidence: 99%

Atrial Fibrillation, Stroke Risk, and Warfarin Therapy Revisited

Björck¹,

Palaszewski

Friberg

et al. 2013

Stroke

303

208

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Background and Purpose— Atrial fibrillation (AF) is a major risk factor for ischemic stroke. This study aims to update the knowledge about AF and associated stroke risk and benefits of anticoagulation. Methods— We extracted data from the hospital, specialized outpatient, and primary healthcare and drug registries in a Swedish region with 1.56 million residents. We identified all individuals who had received an AF diagnosis during the previous 5 years; all stroke events during 2010; and patients with AF aged ≥50 years who had received warfarin during 2009. Results— AF had been diagnosed in 38 446 subjects who were alive at the beginning of 2010 (prevalence of 3.2% in the adult [≥20 years] population); ≈46% received warfarin therapy. In 2010, there were 4565 ischemic stroke events and 861 intracranial hemorrhages. AF had been diagnosed in 38% of ischemic events (≥50% among those aged ≥80 years) and in 23% of intracranial hemorrhages. An AF diagnosis was often lacking in hospital discharge records after stroke events. Warfarin therapy was associated with an odds ratio of 0.50 (confidence interval, 0.43–0.57) for ischemic stroke and, despite an increased risk of intracranial hemorrhage, an odds ratio of 0.57 (confidence interval, 0.50–0.64) for the overall risk for stroke. Conclusions— AF is more common than present guidelines suggest. The attributable risk of AF for ischemic stroke increases with age and is close to that of hypertension in individuals aged ≥80 years. Because a majority of patients with AF with increased risk for stroke had not received anticoagulation therapy, there is a large potential for improvement.

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“…These different figures translate into different incidence of thromboembolic events following CV, reported to be null by some authors, while numerically relevant by others [8,9].…”

mentioning

confidence: 94%

TEE screening in Atrial flutter: A single-centre experience with retrospective validation of a new risk score for the presence of atrial thrombi

Gaibazzi

Piepoli

2008

International Journal of Cardiology

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Atrial flutter and the risk of thromboembolism: A systematic review and meta-analysis

Cited by 79 publications

References 25 publications

Trends in Risk of Stroke in Patients with a Hospital Diagnosis of Nonvalvular Atrial Fibrillation: National Cohort Study in Denmark, 1980–2002

Trends in Risk of Stroke in Patients with a Hospital Diagnosis of Nonvalvular Atrial Fibrillation: National Cohort Study in Denmark, 1980–2002

Atrial Fibrillation, Stroke Risk, and Warfarin Therapy Revisited

TEE screening in Atrial flutter: A single-centre experience with retrospective validation of a new risk score for the presence of atrial thrombi

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