First-Ever Atrial Fibrillation Documented After Hemorrhagic or Ischemic Stroke: The Role of the CHADS(2) Score at the Time of Stroke

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Henriksson, KarinLund University,Lunds universitet,Avdelningen för arbets- och miljömedicin,Institutionen för laboratoriemedicin,Medicinska fakulteten,Division of Occupational and Environmental Medicine, Lund University,Department of Laboratory Medicine,Faculty of Medicine (author)

First-Ever Atrial Fibrillation Documented After Hemorrhagic or Ischemic Stroke : The Role of the CHADS(2) Score at the Time of Stroke

Article/chapterEnglish2011

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2011-03-13
Wiley,2011
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LIBRIS-ID:oai:DiVA.org:uu-154302
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-154302URI
https://doi.org/10.1002/clc.20869DOI
https://lup.lub.lu.se/record/1884028URI
https://gup.ub.gu.se/publication/143496URI
http://kipublications.ki.se/Default.aspx?queryparsed=id:122541858URI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Background: The CHADS(2) score (C, congestive heart failure [CHF]; H, hypertension [HT]; A, age >= 75 y; D, diabetes mellitus; S-2, prior stroke or transient ischemic attack) is used to assess the risk of ischemic stroke in patients with atrial fibrillation (AF). However, its role in patients without documented AF is not well explored. Hypothesis: The goal of the current study was to explore if the incidence of hospitalization with first-ever AF after stroke increased with increasing CHADS(2) score. Methods: We identified 57 636 patients with nonfatal stroke and no documented AF in the Swedish Stroke Register (Riks-Stroke) during 2001-2004 and followed them for a mean of 2.2 years through record linkage to the Inpatient and Cause of Death registers. Cox regression hazard models were used to estimate the relative risk (RR) of new AF following stroke and its association with different CHADS(2) scores. Results: Overall, 2769 patients were hospitalized with new AF (4.8%, 21.7 per 1000 person-years). The incidence increased from 9.6 per 1000 person-years in CHADS(2) score 0 to 42.7 in CHADS(2) score 6, conferring a RR of 4.2 (95% confidence interval [CI]: 2.5-6.8). For CHADS(2) scores 3-5, the RRs were approximately 3 (vs CHADS(2) score 0). Adjusted RRs were 1.9 (95% CI: 1.7-2.1) for CHF, 1.4 (95% CI: 1.3-1.5) for HT, 2.1 (95% CI: 2.0-2.3) for age >= 75 years, 0.9 (95% CI: 0.8-1.0) for diabetes, and 1.0 (95% CI: 0.91-1.07) for previous stroke. The risk of AF was higher in ischemic than in hemorrhagic stroke. Conclusions: In this retrospective register study, the incidence of AF following stroke was strongly influenced by higher CHADS(2) scores where age >= 75 years, CHF, and HT were the contributing CHADS(2) components.

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MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Arbetsmedicin och miljömedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Occupational Health and Environmental Health hsv//eng
MEDICINE
MEDICIN

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Farahmand, Bahman (author)
Åsberg, SignildUppsala universitet,Institutionen för medicinska vetenskaper(Swepub:uu)sigas493 (author)
Terént, AndreasUppsala universitet,Institutionen för medicinska vetenskaper(Swepub:uu)andrtere (author)
Edvardsson, Nils,1942Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xedvni (author)
Avdelningen för arbets- och miljömedicinInstitutionen för laboratoriemedicin (creator_code:org_t)

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In:Clinical Cardiology: Wiley34:5, s. 309-3160160-92891932-8737

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