Relationship Among Atrial Fibrillation, CHADS2 Score and Ischaemic Stroke in Patients With Coronary Artery Disease: A Propensity Score Matching Study

Abstract

Objective: The purpose of this study was to investigate the relationship among atrial fibrillation (AF), CHADS2 score and ischaemic stroke in patients with coronary artery disease.Methods: A total of 2335 patients with coronary artery disease were included. They were divided into a nonischaemic stroke group (n=1997) and an ischaemic stroke group (n=388). Propensity score matching (PSM) was used to match ischaemic stroke patients with nonischaemic stroke patients in a 1:4 ratio. The relationship between AF, CHADS2 score and ischaemic stroke was evaluated using a univariate generalized linear model in different age, body mass index, and coronary artery disease subgroups. Univariate and multivariate generalized linear models were used to evaluate the relationship between AF and ischaemic stroke in different models.Results: Compared with the nonischaemic stroke group, the rate of AF (8.81% vs. 14.20%, P=0.002) in the ischaemic stroke group was higher. The proportion of patients with ischaemic stroke was significantly different between the AF group and the non-AF group (19.04% vs. 28.74%, P=0.003). With increasing CHADS2 score, the incidence of AF gradually increased (P for trend <0.001). With increasing AF burden, the rate of ischaemic stroke increased continuously (P for trend <0.001). Subgroup analysis showed that the trend towards increased stroke risk in the AF group was consistent across the various subgroups. Multivariate analysis demonstrated that paroxysmal and nonparoxysmal AF were not associated with ischaemic stroke compared with the absence of AF.Conclusion: After adjusting for confounding factors, the correlation between AF and ischaemic stroke decreased. Atherosclerotic factors may play an important role in ischaemic stroke in patients with coronary heart disease.