Arrhythmias & electrophysiology
Temporal Trends of Ischemic Stroke Risk in Patients With Incident Atrial Fibrillation Before Anticoagulation
Authors' conclusion
The initial IS risk in AF patients, before the initiation of OAC therapy, has decreased by 25% between 2007 and 2018 despite an increase in both age and stroke risk scores. The decrease has been most pronounced in older women with high stroke risk scores.
Study context
- Population
- Patients with incident atrial fibrillation (AF) before OAC therapy, all levels of care in Finland, 2007–2018 (FinACAF)49.2% women
- Participants
- 129,789 patients
- Exposure
- Ischemic stroke (IS) rates across calendar periods 2007-2010 vs 2015-2018
- Outcome
- IS incidence rate (OAC-free follow-up, after 4-week quarantine from AF diagnosis)
Methodological detailsnationwide
- Nationwide
Main finding
As reported in the abstract
Overall IS rate
| Group | Value | Mean CHA2DS2-VA score |
|---|---|---|
| 2007-2010 | 36.7 events per 1,000 patient-years | 2.5 |
| 2015-2018 | 27.6 events per 1,000 patient-years | 3.0 |
Value
2007-201036.7 events per 1,000 patient-years
2015-201827.6 events per 1,000 patient-years
Mean CHA2DS2-VA score
2007-20102.5
2015-20183.0
- Overall IS rate decrease
- 25%
Observational data: associations, not effects.
Further findings
IS rate in women
- Decrease in IS rate in women, particularly with higher age and CHA2DS2-VA scores
- 32%
IS rate with CHA2DS2-VA score of 1
- IS rate, stable across study period
- 8.2 events per 1,000 patient-years
Original publication
Temporal Trends of Ischemic Stroke Risk in Patients With Incident Atrial Fibrillation Before Anticoagulation. JACC Clin Electrophysiol. Published 18 December 2024. doi:10.
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