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*Atrial Fibrillation

Stroke, Vol 22, 983-988, Copyright © 1991 by American Heart Association


ARTICLES

Atrial fibrillation as an independent risk factor for stroke: the Framingham Study

PA Wolf, RD Abbott and WB Kannel
Department of Neurology, Evans Memorial Department of Clinical Research, Boston, Mass.

The impact of nonrheumatic atrial fibrillation, hypertension, coronary heart disease, and cardiac failure on stroke incidence was examined in 5,070 participants in the Framingham Study after 34 years of follow-up. Compared with subjects free of these conditions, the age-adjusted incidence of stroke was more than doubled in the presence of coronary heart disease (p less than 0.001) and more than trebled in the presence of hypertension (p less than 0.001). There was a more than fourfold excess of stroke in subjects with cardiac failure (p less than 0.001) and a near fivefold excess when atrial fibrillation was present (p less than 0.001). In persons with coronary heart disease or cardiac failure, atrial fibrillation doubled the stroke risk in men and trebled the risk in women. With increasing age the effects of hypertension, coronary heart disease, and cardiac failure on the risk of stroke became progressively weaker (p less than 0.05). Advancing age, however, did not reduce the significant impact of atrial fibrillation. For persons aged 80-89 years, atrial fibrillation was the sole cardiovascular condition to exert an independent effect on stroke incidence (p less than 0.001). The attributable risk of stroke for all cardiovascular contributors decreased with age except for atrial fibrillation, for which the attributable risk increased significantly (p less than 0.01), rising from 1.5% for those aged 50-59 years to 23.5% for those aged 80- 89 years. While these findings highlight the impact of each cardiovascular condition on the risk of stroke, the data suggest that the elderly are particularly vulnerable to stroke when atrial fibrillation is present.(ABSTRACT TRUNCATED AT 250 WORDS)


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CirculationHome page
D. Fatkin, R. Otway, and J. I. Vandenberg
Genes and Atrial Fibrillation: A New Look at an Old Problem
Circulation, August 14, 2007; 116(7): 782 - 792.
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Eur Heart JHome page
Y. Miyasaka, M. E. Barnes, R. C. Petersen, S. S. Cha, K. R. Bailey, B. J. Gersh, G. Casaclang-Verzosa, W. P. Abhayaratna, J. B. Seward, T. Iwasaka, et al.
Risk of dementia in stroke-free patients diagnosed with atrial fibrillation: data from a community-based cohort
Eur. Heart J., August 2, 2007; 28(16): 1962 - 1967.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
A. Y.-J. Shen, J. F. Yao, S. S. Brar, M. B. Jorgensen, and W. Chen
Racial/Ethnic Differences in the Risk of Intracranial Hemorrhage Among Patients With Atrial Fibrillation
J. Am. Coll. Cardiol., July 24, 2007; 50(4): 309 - 315.
[Abstract] [Full Text] [PDF]


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MMCTSHome page
R. J. Damiano Jr and M. Bailey
The Cox-Maze IV procedure for lone atrial fibrillation
MMCTS, July 23, 2007; 2007(0723): 2758.
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CirculationHome page
A. Jahangir, V. Lee, P. A. Friedman, J. M. Trusty, D. O. Hodge, S. L. Kopecky, D. L. Packer, S. C. Hammill, W.-K. Shen, and B. J. Gersh
Long-Term Progression and Outcomes With Aging in Patients With Lone Atrial Fibrillation: A 30-Year Follow-Up Study
Circulation, June 19, 2007; 115(24): 3050 - 3056.
[Abstract] [Full Text] [PDF]


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Eur Heart J SupplHome page
Authors/Task Force Members, L. Ryden, E. Standl, M. Bartnik, G. V. d. Berghe, J. Betteridge, M.-J. de Boer, F. Cosentino, B. Jonsson, M. Laakso, et al.
Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: full text: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD)
Eur. Heart J. Suppl., June 1, 2007; 9(suppl_C): C3 - C74.
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Arch Intern MedHome page
M. D. Gammage, J. V. Parle, R. L. Holder, L. M. Roberts, F. D. R. Hobbs, S. Wilson, M. C. Sheppard, and J. A. Franklyn
Association Between Serum Free Thyroxine Concentration and Atrial Fibrillation
Arch Intern Med, May 14, 2007; 167(9): 928 - 934.
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QJMHome page
N. Anderson, R. Fuller, and N. Dudley
'Rules of thumb' or reflective practice? Understanding senior physicians' decision-making about anti-thrombotic usage in atrial fibrillation
QJM, May 1, 2007; 100(5): 263 - 269.
[Abstract] [Full Text] [PDF]


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StrokeHome page
S. Rastas, A. Verkkoniemi, T. Polvikoski, K. Juva, L. Niinisto, K. Mattila, E. Lansimies, T. Pirttila, and R. Sulkava
Atrial Fibrillation, Stroke, and Cognition: A Longitudinal Population-Based Study of People Aged 85 and Older
Stroke, May 1, 2007; 38(5): 1454 - 1460.
[Abstract] [Full Text] [PDF]