Stroke, Vol 14, 664-667, Copyright © 1983 by American Heart Association
PA Wolf, WB Kannel, DL McGee, SL Meeks, NE Bharucha and PM McNamara
The role of Atrial Fibrillation (AF) as a precursor of stroke was examined
in the Framingham cohort based on 30 years of follow-up during which time
501 strokes occurred. There were 59 persons who sustained stroke in
association with AF excluding those with rheumatic heart disease. AF
increased the risk of stroke five-fold and the excess risk was found to be
independent of the frequently associated cardiac failure and coronary heart
disease. The contribution of AF to stroke risk was also at least as
powerful as that of the other cardiovascular precursors. Stroke associated
with AF was not only independent and substantial but also imminent. There
was a distinct clustering of stroke events at the time of onset of the AF.
Thirty day case-fatality rates were no different in those with strokes
accompanied by AF than not at 17% versus 19% respectively. Recurrences in
those with AF were only slightly more frequent, 25% versus 20%, a
difference that was not statistically significant. Stroke recurrence in the
first 6 months following initial stroke was more than twice as common (47%
versus 20%) in the AF group.
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