Temporal relations between atrial fibrillation and ischaemic stroke and their prognostic impact on mortality
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
Temporal relations between atrial fibrillation and ischaemic stroke and their prognostic impact on mortality. / Camen, Stephan; Ojeda, Francisco M; Niiranen, Teemu; Gianfagna, Francesco; Vishram-Nielsen, Julie K; Costanzo, Simona; Söderberg, Stefan; Vartiainen, Erkki; Donati, Maria Benedetta; Løchen, Maja-Lisa; Pasterkamp, Gerard; Magnussen, Christina; Kee, Frank; Jousilahti, Pekka; Hughes, Maria; Kontto, Jukka; Mathiesen, Ellisiv B; Koenig, Wolfgang; Palosaari, Tarja; Blankenberg, Stefan; de Gaetano, Giovanni; Jørgensen, Torben; Zeller, Tanja; Kuulasmaa, Kari; Linneberg, Allan; Salomaa, Veikko; Iacoviello, Licia; Schnabel, Renate B.
I: Europace, Bind 22, Nr. 4, 2020, s. 522–529.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Temporal relations between atrial fibrillation and ischaemic stroke and their prognostic impact on mortality
AU - Camen, Stephan
AU - Ojeda, Francisco M
AU - Niiranen, Teemu
AU - Gianfagna, Francesco
AU - Vishram-Nielsen, Julie K
AU - Costanzo, Simona
AU - Söderberg, Stefan
AU - Vartiainen, Erkki
AU - Donati, Maria Benedetta
AU - Løchen, Maja-Lisa
AU - Pasterkamp, Gerard
AU - Magnussen, Christina
AU - Kee, Frank
AU - Jousilahti, Pekka
AU - Hughes, Maria
AU - Kontto, Jukka
AU - Mathiesen, Ellisiv B
AU - Koenig, Wolfgang
AU - Palosaari, Tarja
AU - Blankenberg, Stefan
AU - de Gaetano, Giovanni
AU - Jørgensen, Torben
AU - Zeller, Tanja
AU - Kuulasmaa, Kari
AU - Linneberg, Allan
AU - Salomaa, Veikko
AU - Iacoviello, Licia
AU - Schnabel, Renate B
PY - 2020
Y1 - 2020
N2 - AIMS: Limited evidence is available on the temporal relationship between atrial fibrillation (AF) and ischaemic stroke and their impact on mortality in the community. We sought to understand the temporal relationship of AF and ischaemic stroke and to determine the sequence of disease onset in relation to mortality.METHODS AND RESULTS: Across five prospective community cohorts of the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) project we assessed baseline cardiovascular risk factors in 100 132 individuals, median age 46.1 (25th-75th percentile 35.8-57.5) years, 48.4% men. We followed them for incident ischaemic stroke and AF and determined the relation of subsequent disease diagnosis with overall mortality. Over a median follow-up of 16.1 years, N = 4555 individuals were diagnosed solely with AF, N = 2269 had an ischaemic stroke but no AF diagnosed, and N = 898 developed both, ischaemic stroke and AF. Temporal relationships showed a clustering of diagnosis of both diseases within the years around the diagnosis of the other disease. In multivariable-adjusted Cox regression analyses with time-dependent covariates subsequent diagnosis of AF after ischaemic stroke was associated with increased mortality [hazard ratio (HR) 4.05, 95% confidence interval (CI) 2.17-7.54; P < 0.001] which was also apparent when ischaemic stroke followed after the diagnosis of AF (HR 3.08, 95% CI 1.90-5.00; P < 0.001).CONCLUSION: The temporal relations of ischaemic stroke and AF appear to be bidirectional. Ischaemic stroke may precede detection of AF by years. The subsequent diagnosis of both diseases significantly increases mortality risk. Future research needs to investigate the common underlying systemic disease processes.
AB - AIMS: Limited evidence is available on the temporal relationship between atrial fibrillation (AF) and ischaemic stroke and their impact on mortality in the community. We sought to understand the temporal relationship of AF and ischaemic stroke and to determine the sequence of disease onset in relation to mortality.METHODS AND RESULTS: Across five prospective community cohorts of the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) project we assessed baseline cardiovascular risk factors in 100 132 individuals, median age 46.1 (25th-75th percentile 35.8-57.5) years, 48.4% men. We followed them for incident ischaemic stroke and AF and determined the relation of subsequent disease diagnosis with overall mortality. Over a median follow-up of 16.1 years, N = 4555 individuals were diagnosed solely with AF, N = 2269 had an ischaemic stroke but no AF diagnosed, and N = 898 developed both, ischaemic stroke and AF. Temporal relationships showed a clustering of diagnosis of both diseases within the years around the diagnosis of the other disease. In multivariable-adjusted Cox regression analyses with time-dependent covariates subsequent diagnosis of AF after ischaemic stroke was associated with increased mortality [hazard ratio (HR) 4.05, 95% confidence interval (CI) 2.17-7.54; P < 0.001] which was also apparent when ischaemic stroke followed after the diagnosis of AF (HR 3.08, 95% CI 1.90-5.00; P < 0.001).CONCLUSION: The temporal relations of ischaemic stroke and AF appear to be bidirectional. Ischaemic stroke may precede detection of AF by years. The subsequent diagnosis of both diseases significantly increases mortality risk. Future research needs to investigate the common underlying systemic disease processes.
U2 - 10.1093/europace/euz312
DO - 10.1093/europace/euz312
M3 - Journal article
C2 - 31740944
VL - 22
SP - 522
EP - 529
JO - Europace
JF - Europace
SN - 1099-5129
IS - 4
ER -
ID: 237707669