Abstract
Background: Atrial fibrillation (AF) significantly increases the risk of stroke and disease burden; it is an established predictor of poor outcomes after stroke. However, reported differences in outcomes after stroke among elderly patients between AF and non-AF group are conflicting. We aimed to compare differences in outcomes at 1 year and 3 years after stroke among elderly patients (aged ≥ 75 years old) between AF group and non-AF group.Methods: We recruited 1070 consecutive elderly patients who experienced acute ischemic stroke between January 2008 and December 2013 in Jiamusi University First Hospital, China in this study. Information regarding stroke subtype, severity, risk factors, and outcome (mortality, dependency, and recurrence) at 3 and 12 months after stroke were recorded and assessed between AF group and non-AF group.Results: The prevalence of AF was 16.1% overall, with a similar trend in the prevalence of AF between men and women. The AF group were more likely to experience severe stroke compared to the non-AF group (32.0 vs. 11.9%, respectively; P < 0.001). There were no obvious differences between groups regarding the prevalence of hypertension, dyslipidemia, obesity, current smoking, and alcohol drinking but there was a higher prevalence of diabetes in the non-AF group (20.3 vs. 30.1%, P = 0.010). Mortality and dependency rates were significantly higher in the AF group than in the non-AF group at 1 year after stroke (29.6 vs. 17.8%, P = 0.001 for mortality; and 59.5 vs. 36.1%, P = 0.010 for dependency) and 3 years after stroke (46.1 vs. 33.2%, P = 0.032 for mortality; and 70.7 vs. 49.2%, P = 0.010 for dependency); however, there was no significant between-groups differences in rates of recurrence across the follow-up periods. The results for dependency remained stable after adjustment for sex, stroke severity, and stroke risk factors at 3 years after stroke (OR, 2.26; 95% CI, 1.06–4.81; P = 0.034); however, the relationship between AF and mortality and recurrence disappeared after adjusting for these covariatesConclusion: These findings suggest that it is crucial to highlight the treatment of elderly stroke patients with AF in order to reduce poor outcomes among the elderly and to reduce the burden of AF in China.
Highlights
Stroke was the second most common cause of death and the third most common cause of reduced disability-adjusted lifeyears (DALYs) worldwide in 2010 (Lozano et al, 2012)
Outcomes at 1 year poststroke were available for 867 elderly stroke patients (93.2%), after excluding 63 patients lost to follow-up, and outcomes at 3 years post-stroke were available for 453 elderly stroke patients (91.5%), after excluding 42 patients lost to follow-up (Figure 1)
1070 elderly stroke patients were included in this study (172 in the Atrial fibrillation (AF) group and 898 in the non-AF group); the prevalence of AF was 16.1% overall; similar for men and women (15.0 vs. 17.5%, P = 0.256)
Summary
Stroke was the second most common cause of death and the third most common cause of reduced disability-adjusted lifeyears (DALYs) worldwide in 2010 (Lozano et al, 2012). Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia It is an independent risk factor for stroke and is associated with marked morbidity, mortality, and socioeconomic burden (Wolf et al, 1991, 1998; Chugh et al, 2001). Atrial fibrillation (AF) significantly increases the risk of stroke and disease burden; it is an established predictor of poor outcomes after stroke. Reported differences in outcomes after stroke among elderly patients between AF and non-AF group are conflicting. We aimed to compare differences in outcomes at 1 year and 3 years after stroke among elderly patients (aged ≥ 75 years old) between AF group and non-AF group
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