Epidemiology of ischemic stroke from atrial fibrillation in Dijon, France, from 1985 to 2006

被引:58
作者
Bejot, Y. [1 ,2 ]
Salem, D. Ben [3 ]
Osseby, G. V. [1 ,2 ]
Couvreur, G. [1 ,2 ]
Durier, J. [1 ,2 ]
Marie, C. [4 ]
Cottin, Y. [5 ,6 ,7 ]
Moreau, T. [1 ,2 ]
Giroud, M. [1 ,2 ]
机构
[1] Univ Hosp, Dijon Stroke Registry, Dept Neurol, INSERM,EA4184, F-21000 Dijon, France
[2] Univ Hosp, EA4184, Stroke Registry Dijon, Inst Veille Sanit, F-21000 Dijon, France
[3] Univ Hosp, Dept Neuroimaging, F-21000 Dijon, France
[4] Univ Burgundy, INSERM, Lab Pharmacodynam, U887, Dijon, France
[5] Univ Burgundy, Univ Hosp, IFR Sante STIC, LPPCE,Dept Cardiol, Dijon, France
[6] Univ Burgundy, Univ Hosp, IFR Sante STIC, LPPCE,Observ Infarctus Cote Or RICO, Dijon, France
[7] Fac Med Dijon, Dijon, France
关键词
COMMUNITY STROKE; RISK-FACTORS; INCIDENCE RATES; WARFARIN USE; POPULATION; SUBTYPES; ANTICOAGULATION; PREVALENCE; MANAGEMENT; TRENDS;
D O I
10.1212/01.wnl.0000341280.31919.bd
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Atrial fibrillation (AF) is strongly associated with age, and epidemiologic studies are needed to evaluate the impact of both aging of the population and the use of anticoagulant therapy in patients with AF on the incidence of cardioembolic stroke with AF (CE/AF stroke). Methods: We evaluated trends in incidence rates, risk factors, prestroke therapy, and survival in CE/AF stroke from a prospective population-based registry, from 1985 to 2006. Results: A total of 3,064 ischemic strokes, including 572 (18.7%) CE/ AF strokes, were recorded. Over the 22 years, a decrease in the incidence of overall CE/ AF stroke was noted (incidence rate ratio 0.9858, 95% confidence interval [CI] 0.9731-0.9986; p = 0.03). We observed a higher prevalence of previous AF, previous myocardial infarction, and patients aged > 70 years in CE/ AF stroke (p < 0.0001) whereas hypercholesterolemia was more prevalent in other ischemic strokes (p = 0.003). A significant increase in the use of anticoagulants and antiplatelet agents was noted, and was particularly pronounced for CE/ AF stroke with previous AF. For CE/ AF stroke, survival rates were 72% at 1 month (95% CI 0.68-0.76), 52% at 1 year (95% CI 0.48-0.56), and 43% at 2 years (95% CI 0.39-0.48), and remained lower than those of other ischemic stroke. Conclusions: The decrease in the incidence of cardioembolic/atrial fibrillation stroke in our study was probably due to a slight increase in the utilization of antithrombotic therapy in patients with atrial fibrillation, but the use of such therapies will have to increase further because of the expected aging of the population in coming years. Neurology (R) 2009; 72: 346-353
引用
收藏
页码:346 / 353
页数:8
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