Temporal relations between atrial fibrillation and ischaemic stroke and their prognostic impact on mortality

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Fältnamn	Indikatorer	Metadata
000		04318naa a2200673 4500
001		oai:DiVA.org:umu-172560
003		SwePub
008		200622s2020 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1725602 URI
024	7	a https://doi.org/10.1093/europace/euz3122 DOI
040		a (SwePub)umu
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Camen, Stephan4 aut
245	1 0	a Temporal relations between atrial fibrillation and ischaemic stroke and their prognostic impact on mortality
264		c 2019-11-18
264	1	b Oxford University Press,c 2020
338		a print2 rdacarrier
520		a Aims Limited evidence is available on the temporal relationship between atrial fibrillation (AF) and ischaemic stroke and their impact on mortality in the community. We sought to understand the temporal relationship of AF and ischaemic stroke and to determine the sequence of disease onset in relation to mortality. Methods and results Across five prospective community cohorts of the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) project we assessed baseline cardiovascular risk factors in 100 132 individuals, median age 46.1 (25th-75th percentile 35.8-57.5) years, 48.4% men. We followed them for incident ischaemic stroke and AF and determined the relation of subsequent disease diagnosis with overall mortality. Over a median follow-up of 16.1 years, N = 4555 individuals were diagnosed solely with AF, N = 2269 had an ischaemic stroke but no AF diagnosed, and N = 898 developed both, ischaemic stroke and AF. Temporal relationships showed a clustering of diagnosis of both diseases within the years around the diagnosis of the other disease. In multivariable-adjusted Cox regression analyses with time-dependent covariates subsequent diagnosis of AF after ischaemic stroke was associated with increased mortality [hazard ratio (HR) 4.05, 95% confidence interval (CI) 2.17-7.54; P < 0.001] which was also apparent when ischaemic stroke followed after the diagnosis of AF (HR 3.08, 95% CI 1.90-5.00; P < 0.001). Conclusion The temporal relations of ischaemic stroke and AF appear to be bidirectional. Ischaemic stroke may precede detection of AF by years. The subsequent diagnosis of both diseases significantly increases mortality risk. Future research needs to investigate the common underlying systemic disease processes.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
653		a Atrial fibrillation
653		a Ischaemic stroke
653		a Temporal relationship
653		a Cohort study
700	1	a Ojeda, Francisco M.4 aut
700	1	a Niiranen, Teemu4 aut
700	1	a Gianfagna, Francesco4 aut
700	1	a Vishram-Nielsen, Julie K.4 aut
700	1	a Costanzo, Simona4 aut
700	1	a Söderberg, Stefanu Umeå universitet,Kardiologi4 aut0 (Swepub:umu)stso0001
700	1	a Vartiainen, Erkki4 aut
700	1	a Donati, Maria Benedetta4 aut
700	1	a Løchen, Maja-Lisa4 aut
700	1	a Pasterkamp, Gerard4 aut
700	1	a Magnussen, Christina4 aut
700	1	a Kee, Frank4 aut
700	1	a Jousilahti, Pekka4 aut
700	1	a Hughes, Maria4 aut
700	1	a Kontto, Jukka4 aut
700	1	a Mathiesen, Ellisiv B.4 aut
700	1	a Koenig, Wolfgang4 aut
700	1	a Palosaari, Tarja4 aut
700	1	a Blankenberg, Stefan4 aut
700	1	a de Gaetano, Giovanni4 aut
700	1	a Jorgensen, Torben4 aut
700	1	a Zeller, Tanja4 aut
700	1	a Kuulasmaa, Kari4 aut
700	1	a Linneberg, Allan4 aut
700	1	a Salomaa, Veikko4 aut
700	1	a Iacoviello, Licia4 aut
700	1	a Schnabel, Renate B.4 aut
710	2	a Umeå universitetb Kardiologi4 org
773	0	t Europaced : Oxford University Pressg 22:4, s. 522-529q 22:4<522-529x 1099-5129x 1532-2092
856	4	u https://academic.oup.com/europace/article-pdf/22/4/522/32991362/euz312.pdf
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-172560
856	4 8	u https://doi.org/10.1093/europace/euz312

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