Risk of Cerebrovascular Accident After a First Diagnosis of Atrial Fibrillation

Ruigómez, Ana; Rodrı́guez, Luis A. Garcı́a; Johansson, Saga; Wallander, Mari‐Ann; Edvardsson, Nils

doi:10.1002/clc.20178

Cited by 8 publications

(6 citation statements)

References 20 publications

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“…Trifirò and colleagues observed an increased risk of ischemic stroke among users of SSRIs (adjusted OR = 1.39, 95%CI = 1.03–1.86). Given that cAF is a major risk factor for stroke, our study excludes an indirect effect due to ADs‐related cAF. On the other hand, our results show a nonsignificant trend of risk reduction of cAF moving from a short to a longer duration of use as well as from a low to a greater degree of adherence to ADs.…”

Section: Discussionmentioning

confidence: 99%

The use of antidepressants and the risk of chronic atrial fibrillation

Lapi

Azoulay

Kezouh

et al. 2015

The Journal of Clinical Pharma

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Serotonin stimulation of the 5HT4 receptor might be responsible for an increased risk of atrial fibrillation (AF). Thus, we assessed whether the use of antidepressants (ADs) is associated with an increased risk of chronic AF (cAF). Using the UK Clinical Practice Research Datalink, a nested case-control analysis was conducted within a cohort of new AD users having a diagnosis of depression and/or anxiety. Cases of cAF occurring during follow-up were individually matched with up to 10 controls on age, sex, year of cohort entry, and duration of follow-up. Conditional logistic regression was used to estimate rate ratios (RRs) and 95% confidence intervals (CIs) of cAF associated with current and recent use of ADs, when compared to past use. The cohort included 116,125 new AD users, of whom 1,271 were diagnosed with cAF during follow-up (incidence rate: 1.6 per 1,000 person-years). The adjusted RR of cAF associated with current and recent use of ADs was 0.98 (95%CI: 0.86-1.12) and 1.02 (95%CI: 0.86-1.30), respectively. No association was observed when ADs were classified according to their potency in reducing serotonin reuptake. These findings suggest that exposure to ADs is not associated with an increased risk of cAF.

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Section: Discussionmentioning

confidence: 99%

The use of antidepressants and the risk of chronic atrial fibrillation

Lapi

Azoulay

Kezouh

et al. 2015

The Journal of Clinical Pharma

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“…Following review of the abstract, 8 studies were initially identified as eligible for inclusion, but 2 of these were subsequently excluded after assessment of the study methods. One of these was excluded because the relative risk of stroke-related AF was not reported [35] and the other because only univariable analyses were provided [36]. Of the 6 studies included in the final analysis, 5 were prospective cohort studies [26,37,38,39,40] and 1 was a case-control study [21].…”

Section: Resultsmentioning

confidence: 99%

The Prevalence, Impact and Economic Implications of Atrial Fibrillation in Stroke: What Progress Has Been Made?

Andrew¹,

Thrift²,

Cadilhac³

2013

Neuroepidemiology

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Atrial fibrillation (AF) is a major risk factor for stroke, especially in the elderly. Increased life expectancies mean that AF-related stroke is a growing global public health concern. Improvements in the detection, treatment and prevention of the consequences of AF have occurred in recent years. However, the extent to which these improvements have impacted on the prevalence of AF, the risk of AF-related stroke and subsequent economic costs are unknown. This review provides a contemporary assessment of the epidemiological data on AF-related stroke aimed at assessing the effectiveness of primary prevention strategies and associated economic implications with reductions in stroke incidence. A systematic review of the literature was performed. Appropriately designed studies were identified and retrieved. Evidence on changes in the prevalence of AF, the risk of stroke associated with AF and the excess cost of AF-related stroke over the last 30 years was summarised. The results provide evidence that the age-adjusted prevalence of AF and the relative risk of stroke associated with AF has remained relatively constant. Unless action is taken to improve detection of AF and reduce its consequences, a considerable increase in the social and economic burden associated with AF-related stroke is likely.

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“…In previous studies, we identified a group of patients aged 40-89 years with a first ever recorded diagnosis of AF in 1996 [8,[17][18][19]. The AF diagnosis was validated through a questionnaire sent to primary care physicians, as detailed previously [19].…”

Section: Study Populationmentioning

confidence: 99%

“…The AF diagnosis was validated through a questionnaire sent to primary care physicians, as detailed previously [19]. For the purposes of this study, patients whose arrhythmia persisted for more than 1 week were classified as having chronic AF (CAF).…”

Section: Study Populationmentioning

confidence: 99%