Prevalence of atrial fibrillation and association of atrial fibrillation with prior and new thromboembolic stroke in older patients.
OBJECTIVE
To correlate atrial fibrillation with the incidence of new thromboembolic (TE) stroke in older patients with and without prior TE stroke.


METHODS
In a prospective study of 2101 older patients, electrocardiograms showed that atrial fibrillation was present in 283 patients (13%). At 42-month mean follow-up, atrial fibrillation was associated with the incidence of new TE stroke in patients with and without prior TE stroke.


METHODS
A large long-term health care facility where 2101 older patients were studied.


METHODS
The 2101 patients included 1451 women and 650 men, mean age 81 +/- 8 years (range 60 to 103).


RESULTS
Atrial fibrillation was present in 283 of 2101 patients (13%). The mean age was 84 +/- 7 years in patients with atrial fibrillation and 81 +/- 8 years in patients with sinus rhythm (P = .0001). The prevalence of atrial fibrillation was 5% in patients aged 60 to 70 years, 14% in patients aged 71 to 80 years, 13% in patients aged 81 to 90 years, and 22% in patients aged 91 to 103 years (P < .0001). Mean follow-up was 31 +/- 18 months in patients with atrial fibrillation and 44 +/- 27 months in patients with sinus rhythm (P = .0001). Previous TE stroke occurred in 123 of 283 patients (43%) with atrial fibrillation and in 431 of 1818 patients (24%) with sinus rhythm (P < .0001). New TE stroke occurred in 131 of 283 patients (46%) with atrial fibrillation and in 303 of 1818 patients (17%) with sinus rhythm (P < .0001). The log-rank test showed that patients with atrial fibrillation had a significantly higher probability of developing new TE stroke than those with sinus rhythm (P < .0001). The multivariate Cox regression model showed that independent risk factors for new TE stroke were male sex (relative risk = 1.3), prior TE stroke (relative risk = 3.1), and atrial fibrillation (relative risk = 3.3).


CONCLUSIONS
Atrial fibrillation, prior TE stroke, and male sex are independent risk factors for the development of new TE stroke in older patients.
Aronow
W S
WS
Hebrew Hospital Home, Bronx, New York 10475, USA.
Ahn
C
C
Gutstein
H
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D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000453:epidemiology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D015994:Incidence; D002542:Intracranial Embolism and Thrombosis / Q000150:complications* / Q000453:epidemiology; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis