The risk and timing of acute ischemic stroke after electrical cardioversion for atrial fibrillation in Taiwan: A nationwide population-based cohort study

2021 ◽  
Author(s):  
Chih-Kang Huang ◽  
Jen-Chun Wang ◽  
Chi-Hsiang Chung ◽  
Sy-Jou Chen ◽  
Wen-I Liao ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Population Based ◽  
Electrical Cardioversion

scholarly journals Acute cardiovascular events and all-cause mortality in patients with hyperthyroidism: a population-based cohort study

2017 ◽  
Vol 176 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Olaf M Dekkers ◽  
Erzsébet Horváth-Puhó ◽  
Suzanne C Cannegieter ◽  
Jan P Vandenbroucke ◽  
Henrik Toft Sørensen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Cardiovascular Events ◽  
Population Based ◽  
Arterial Embolism ◽  
Registration System ◽  
Increased Risk ◽  
All Cause Mortality

Objective Several studies have shown an increased risk for cardiovascular disease (CVD) in hyperthyroidism, but most studies have been too small to address the effect of hyperthyroidism on individual cardiovascular endpoints. Our main aim was to assess the association among hyperthyroidism, acute cardiovascular events and mortality. Design It is a nationwide population-based cohort study. Data were obtained from the Danish Civil Registration System and the Danish National Patient Registry, which covers all Danish hospitals. We compared the rate of all-cause mortality as well as venous thromboembolism (VTE), acute myocardial infarction (AMI), ischemic and non-ischemic stroke, arterial embolism, atrial fibrillation (AF) and percutaneous coronary intervention (PCI) in the two cohorts. Hazard ratios (HR) with 95% confidence intervals (95% CI) were estimated. Results The study included 85 856 hyperthyroid patients and 847 057 matched population-based controls. Mean follow-up time was 9.2 years. The HR for mortality was highest in the first 3 months after diagnosis of hyperthyroidism: 4.62, 95% CI: 4.40–4.85, and remained elevated during long-term follow-up (>3 years) (HR: 1.35, 95% CI: 1.33–1.37). The risk for all examined cardiovascular events was increased, with the highest risk in the first 3 months after hyperthyroidism diagnosis. The 3-month post-diagnosis risk was highest for atrial fibrillation (HR: 7.32, 95% CI: 6.58–8.14) and arterial embolism (HR: 6.08, 95% CI: 4.30–8.61), but the risks of VTE, AMI, ischemic and non-ischemic stroke and PCI were increased also 2- to 3-fold. Conclusions We found an increased risk for all-cause mortality and acute cardiovascular events in patients with hyperthyroidism.

Incidence and predictors of left atrium thrombus in acute ischemic stroke patients without atrial fibrillation: a single center cohort study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Cinar ◽  
M.I Hayiroglu ◽  
V Cicek ◽  
S Asal ◽  
M.M Atmaca ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Left Atrium ◽  
Characteristic Curve ◽  
Multivariate Logistic Regression Analysis ◽  
Single Center ◽  
Stroke Patients ◽  
Previous Diagnosis

Abstract Introduction The present study aimed to determine independent predictors of left atrial thrombus (LAT) in acute ischemic stroke patients without atrial fibrillation (AF) using transesophageal echocardiography (TEE). Material and methods In this single center, retrospective cohort study, we enrolled 149 consecutive acute ischemic stroke patients. All of the patients underwent TEE examination to detect LAT within 10 days following admission. Multivariate logistic regression analysis was performed to assess independent predictors of LAT. Results Among all cases, 14 patients (9.3%) had a diagnosis of LAT on TEE examination. In a multivariate analysis; a previous diagnosis of cerebrovascular accident, elevated mean platelet volume (MPV), low left ventricle ejection fraction (EF) and a reduced left atrium appendix (LAA) peak emptying velocity were independent predictors of LAT. The area of MPV under the receiver operating characteristic curve analysis was 0.70 (95% CI: 0.57–0.83; p=0.011). With the optimal cut-off value of 9.45, MPV had a sensitivity of 71.4% and a specificity of 63% to predict LAT. Conclusion Patients with low ventricle EF and elevated MPV should undergo further TEE examination for the possibility of cardio-embolic source. In addition, this research may provide novel information with respect to the applicability of MPV to predict LAT in acute ischemic stroke patients without AF. Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals Association between exercise habits and stroke, heart failure, and mortality in Korean patients with incident atrial fibrillation: A nationwide population-based cohort study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (6) ◽  
pp. e1003659
Author(s):  
Hyo-Jeong Ahn ◽  
So-Ryoung Lee ◽  
Eue-Keun Choi ◽  
Kyung-Do Han ◽  
Jin-Hyung Jung ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Lower Risk ◽  
Population Based ◽  
Health Examination ◽  
Regular Exercise ◽  
Exercise Habits ◽  
Before And After

Background There is a paucity of information about cardiovascular outcomes related to exercise habit change after a new diagnosis of atrial fibrillation (AF). We investigated the association between exercise habits after a new AF diagnosis and ischemic stroke, heart failure (HF), and all-cause death. Methods and findings This is a nationwide population-based cohort study using data from the Korea National Health Insurance Service. A retrospective analysis was performed for 66,692 patients with newly diagnosed AF between 2010 and 2016 who underwent 2 serial health examinations within 2 years before and after their AF diagnosis. Individuals were divided into 4 categories according to performance of regular exercise, which was investigated by a self-reported questionnaire in each health examination, before and after their AF diagnosis: persistent non-exercisers (30.5%), new exercisers (17.8%), exercise dropouts (17.4%), and exercise maintainers (34.2%). The primary outcomes were incidence of ischemic stroke, HF, and all-cause death. Differences in baseline characteristics among groups were balanced considering demographics, comorbidities, medications, lifestyle behaviors, and income status. The risks of the outcomes were computed by weighted Cox proportional hazards models with inverse probability of treatment weighting (IPTW) during a mean follow-up of 3.4 ± 2.0 years. The new exerciser and exercise maintainer groups were associated with a lower risk of HF compared to the persistent non-exerciser group: the hazard ratios (HRs) (95% CIs) were 0.95 (0.90–0.99) and 0.92 (0.88–0.96), respectively (p < 0.001). Also, performing exercise any time before or after AF diagnosis was associated with a lower risk of mortality compared to persistent non-exercising: the HR (95% CI) was 0.82 (0.73–0.91) for new exercisers, 0.83 (0.74–0.93) for exercise dropouts, and 0.61 (0.55–0.67) for exercise maintainers (p < 0.001). For ischemic stroke, the estimates of HRs were 10%–14% lower in patients of the exercise groups, yet differences were statistically insignificant (p = 0.057). Energy expenditure of 1,000–1,499 MET-min/wk (regular moderate exercise 170–240 min/wk) was consistently associated with a lower risk of each outcome based on a subgroup analysis of the new exerciser group. Study limitations include recall bias introduced due to the nature of the self-reported questionnaire and restricted external generalizability to other ethnic groups. Conclusions Initiating or continuing regular exercise after AF diagnosis was associated with lower risks of HF and mortality. The promotion of exercise might reduce the future risk of adverse outcomes in patients with AF.

scholarly journals Influenza vaccination might reduce the risk of ischemic stroke in patients with atrial fibrillation: A population-based cohort study

Oncotarget ◽  
2017 ◽  
Vol 8 (68) ◽  
pp. 112697-112711 ◽  
Author(s):  
Pai-Feng Kao ◽  
Ju-Chi Liu ◽  
Yi-Ping Hsu ◽  
Li-Chin Sung ◽  
Tsung-Yeh Yang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Influenza Vaccination ◽  
Population Based

scholarly journals Association between body mass index and the risk of atrial fibrillation and ischemic stroke according to age: a nationwide population-based cohort study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
H J Ahn ◽  
S R Lee ◽  
E K Choi ◽  
K D Han ◽  
S I Kwon ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Body Mass ◽  
Age Groups ◽  
The Elderly ◽  
Population Based ◽  
Age Group ◽  
Increased Risk

Abstract Background Atrial fibrillation (AF) and ischemic stroke (IS) are two significant cardiovascular diseases that confer an enormous healthcare burden. A limited study comprehensively evaluated the association between full ranges of body mass index (BMI), including underweight, and AF or IS risks, especially in the different age subgroups. Purpose We investigated the association between BMI and AF and IS incidence according to the Korean population's age groups. Methods This was a nationwide population-based cohort study using data from the Korea National Health Insurance Service, including 9 194 477 healthy adults who underwent a medical examination in 2009. We stratified the study population into three age subgroups: age 20–39 (young, 33.1%), age 40–64 (middle-aged, 56.3%), and age over 65 years (elderly, 10.6%). In each age group, the individuals were categorized based on BMI (kg/m2) into underweight (&lt;18.5), normal (18.5 to &lt;23), overweight (23 to &lt;25), obese I (25 to &lt;30), and obese II (≥30). The first occurrences of AF and IS were followed up until December 31, 2018. According to BMI in each age group, the risks of AF and IS were analyzed by Cox proportional hazards regression with 95% confidence intervals (CI) by adjusting age, sex, lifestyle behaviors, and comorbidities. Results Overall, both underweight and higher BMI were associated with an increased risk of AF and stroke across all age groups. The increased risk of AF for patients with obese II was slightly accentuated compared to patients with normal BMI in the young population than elderly population (hazard ratio [HR] 1.78, 95% CI 1.63–1.94 for age 20–39 years; HR 1.55, 95% CI 1.48–1.61 for age ≥65 years, respectively). For underweight individuals, however, the increased risk of AF became more prominent in the elderly: HR and 95% CI was 1.12 (1.07–1.17) in the age over 65 years old, and 1.05 (0.94–1.16) in the age 20–39. Regarding IS, the young group presented a considerable increment in the magnitude of HRs in both underweight and higher BMI groups. However, the association between the BMI and stroke risk became attenuated in the elderly: HRs and 95% CI in underweight and obese II individuals were 1.10 (0.93–1.30) and 2.223 (1.99–2.49) in the age 20–39 group, whereas 0.97 (0.93–1.01) and 1.03 (0.98–1.08) in the age over 65 years old. Conclusions Underweight as well as obesity was associated with increased risks of AF and IS in the general population. In both AF and IS, the gradient of risks according to BMI was apparent at young ages; thus, maintaining normal body weight should be warranted in early life. An interplay of several factors other than BMI may contribute to ischemic stroke in the old ages, requiring integrated risk management in older patients. FUNDunding Acknowledgement Type of funding sources: None.

Does Digoxin Increase the Risk of Ischemic Stroke and Mortality in Atrial Fibrillation? A Nationwide Population-Based Cohort Study

2014 ◽  
Vol 30 (10) ◽  
pp. 1190-1195 ◽  
Author(s):  
Tze-Fan Chao ◽  
Chia-Jen Liu ◽  
Su-Jung Chen ◽  
Kang-Ling Wang ◽  
Yenn-Jiang Lin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Population Based
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