Mexican Americans with atrial fibrillation have more recurrent strokes than do non-Hispanic whites.
OBJECTIVE
Atrial fibrillation is a common cause of stroke with a known preventive treatment. We compared poststroke recurrence and survival in Mexican Americans (MAs) and non-Hispanic whites (NHWs) with atrial fibrillation in a population-based study.


METHODS
Using surveillance methods from the Brain Attack Surveillance in Corpus Christi Project, cases of ischemic stroke/transient ischemic attack with atrial fibrillation were prospectively identified from January 2000 to June 2008. Recurrent stroke and all-cause mortality were compared by ethnicity with survival analysis methods.


RESULTS
A total of 236 patients were available (88 MAs, 148 NHWs). MAs were younger than NHWs, with no ethnic differences in severity of the first stroke or proportion discharged on warfarin. MAs had a higher risk of stroke recurrence than did NHWs (Kaplan-Meier estimates of survival free of stroke recurrence risk at 28 days and 1 year were 0.99 and 0.85 in MAs and 0.98 and 0.96 in NHWs, respectively; P=0.01, log-rank test), which persisted despite adjustment for age and sex (hazard ratio=2.46; 95% CI, 1.19-5.11). Severity of the recurrent stroke was higher in MAs than in NHWs (P=0.02). There was no ethnic difference in survival after stroke in unadjusted analysis or after adjusting for demographic and clinical factors (hazard ratio=1.03; 95% CI, 0.63-1.67).


CONCLUSIONS
MAs with atrial fibrillation have a higher stroke recurrence risk and more severe recurrences than do NHWs but no difference in all-cause mortality. Aggressive stroke prevention measures focused on MAs are warranted.
Simpson
Jennifer R
JR
University of Michigan Cardiovascular Center, Ann Arbor, MI, USA.
Zahuranec
Darin B
DB
Lisabeth
Lynda D
LD
Sánchez
Brisa N
BN
Skolarus
Lesli E
LE
Mendizabal
Jorge E
JE
Smith
Melinda A
MA
Garcia
Nelda M
NM
Morgenstern
Lewis B
LB
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000208:ethnology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D011159:Population Surveillance; D011446:Prospective Studies; D012008:Recurrence; D012306:Risk; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D020521:Stroke / Q000208:ethnology* / Q000401:mortality*; D013781:Texas; D044465:White People