Abstract TP388: Timing Of Diagnosis Of Atrial Fibrillation Relative To Ischemic Stroke And Transient Ischemic Attack
OBJECTIVES: To determine the frequency of initial atrial fibrillation (AF) diagnosis prior to, concurrent with, or subsequent to incident ischemic stroke and ischemic stroke or transient ischemic attack (TIA).
METHODS: A large healthcare claims database (MarketScan) was queried to identify adult patients with an inpatient diagnosis of ischemic stroke between 2004 and 2010. Inpatient or outpatient diagnoses of AF were identified on claims prior to hospitalization admission for stroke, during the hospital stay, or following discharge. Stroke patients were categorized as to whether initial AF diagnosis occurred prior, concurrent, or subsequent to stroke or diagnosis was never made. Restrictions on minimum health plan pre-enrollment prior to incident stroke were applied for sensitivity analysis of estimates of patients diagnosed with AF. Additional estimates of prior, concurrent and subsequent initial AF diagnosis were performed for patients with either incident inpatient stroke/TIA or outpatient TIA diagnosis.
RESULTS: Of the 303,555 patients identified with an inpatient diagnosis of stroke and 795,612 patients with either inpatient stroke/TIA or outpatient TIA, 48.4% and 45.1% were male, respectively. Average ages were 68.2 (SD 15.8) and 66.1 (SD 15.6), respectively. The majority of patients never had a diagnosis of AF; a minority had a concurrent diagnosis, while a larger percentage had a subsequent diagnosis (Table).
CONCLUSIONS: A proportion of the 12.4% of stroke and 8.9% of stroke/TIA patients with concurrent or subsequent AF diagnosis may have had undetected / paroxysmal AF at the incident stroke or TIA. Concurrent AF diagnoses alone may underestimate the percentage of patients with undetected AF at the time of stroke or TIA. More aggressive efforts to diagnose AF may be beneficial, although additional research is needed to better quantify the current burden of undiagnosed AF among stroke patients.
- © 2012 by American Heart Association, Inc.