title: Increasing atrial fibrillation prevalence in acute ischemic stroke and TIA.
abstract: OBJECTIVE
  To evaluate trends in atrial fibrillation (AF) prevalence in acute ischemic stroke (AIS) and TIA in the United States.
  
  
  METHODS
  We used the Nationwide Inpatient Sample to retrospectively compute weighted prevalence of AF in AIS (n = 4,355,140) and TIA (n = 1,816,459) patients admitted to US hospitals from 2004 to 2013. Multivariate-adjusted models were used to evaluate the association of AF with clinical factors, mortality, length of stay, and cost.
  
  
  RESULTS
  From 2004 to 2013, AF prevalence increased by 22% in AIS (20%-24%) and by 38% in TIA (12%-17%). AF prevalence varied by age (AIS: 6% in 50-59 vs 37% in ≥80 years; TIA: 4% in 50-59 vs 24% in ≥80 years), sex (AIS: male 19% vs female 25%; TIA: male 15% vs female 14%), race (AIS: white 26% vs black 12%), and region (AIS: Northeast 25% vs South 20%). Advancing age, female sex, white race, high income, and large hospital size were associated with increased odds of AF in AIS. AF in AIS was a risk factor for in-hospital death (odds ratio 1.93, 95% confidence interval 1.89-1.98) but mortality in AIS with AF decreased from 11.6% to 8.3% (p < 0.001). Compared to no AF, AF was associated with increased cost of $2,310 and length of stay 1.1 days in AIS.
  
  
  CONCLUSIONS
  AF prevalence in AIS and TIA has continued to increase. Disparity in AF prevalence in AIS and TIA exists by patient and hospital factors. AF is associated with increased mortality in AIS. Innovative AIS preventive strategies are needed in patients with AF, especially in the elderly.
authors.affiliation: From the Department of Neurology (F.O.O., S.C., J.G.R., R.L.S., A.M.M.), University of Miami Miller School of Medicine, FL; and Department of Endovascular Neurosurgery (P.K.), Brigham and Women's Hospital, Boston, MA. Fadar.otite@jhsmiami.org.
authors.forename: Fadar Oliver
authors.initials: FO
authors.lastname: Otite
authors.affiliation: From the Department of Neurology (F.O.O., S.C., J.G.R., R.L.S., A.M.M.), University of Miami Miller School of Medicine, FL; and Department of Endovascular Neurosurgery (P.K.), Brigham and Women's Hospital, Boston, MA.
authors.forename: Priyank
authors.initials: P
authors.lastname: Khandelwal
authors.affiliation: From the Department of Neurology (F.O.O., S.C., J.G.R., R.L.S., A.M.M.), University of Miami Miller School of Medicine, FL; and Department of Endovascular Neurosurgery (P.K.), Brigham and Women's Hospital, Boston, MA.
authors.forename: Seemant
authors.initials: S
authors.lastname: Chaturvedi
authors.affiliation: From the Department of Neurology (F.O.O., S.C., J.G.R., R.L.S., A.M.M.), University of Miami Miller School of Medicine, FL; and Department of Endovascular Neurosurgery (P.K.), Brigham and Women's Hospital, Boston, MA.
authors.forename: Jose G
authors.initials: JG
authors.lastname: Romano
authors.affiliation: From the Department of Neurology (F.O.O., S.C., J.G.R., R.L.S., A.M.M.), University of Miami Miller School of Medicine, FL; and Department of Endovascular Neurosurgery (P.K.), Brigham and Women's Hospital, Boston, MA.
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.affiliation: From the Department of Neurology (F.O.O., S.C., J.G.R., R.L.S., A.M.M.), University of Miami Miller School of Medicine, FL; and Department of Endovascular Neurosurgery (P.K.), Brigham and Women's Hospital, Boston, MA.
authors.forename: Amer M
authors.initials: AM
authors.lastname: Malik
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001281:Atrial Fibrillation / Q000453:epidemiology*; D002545:Brain Ischemia / Q000150:complications*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D002546:Ischemic Attack, Transient / Q000453:epidemiology*; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult