Abstract 11036: High CHADS2 and CHA2DS2-VASc Scores Predict New Onset Atrial Fibrillation During 10-year Follow-up in Lund Stroke Register
Introduction: Though AF is a risk factor for ischemic stroke and high AF prevalence in stroke patients has been reported, the impact of ischemic stroke on risk for new onset AF during follow-up is not clear. We aimed to assess predictors of new-onset AF during 10-years follow-up in relation to the ischemic stroke history in patients enrolled in the Lund Stroke Register (LSR).
Methods: Patients with first-ever ischemic stroke (n=336, age 74±11 y, 200 men) and 1:1 age- and gender-matched control subjects without stroke were enrolled in LSR from Mar 2001 to Feb 2002. AF history prior to admission and the date of new-onset AF during FU were assessed using medical records, ECG database review and record linkage with the Swedish Hospital Discharge Register. Cardiovascular risk profile was evaluated using CHADS2 and CHA2DS2-VASc scores.
Results: By enrolment, 32 % of stroke patients and 13% of controls had AF history (p < 0.001). Among 519 subjects without AF at baseline (227 pts with stroke and 292 control subjects), AF was detected in 39 (17%) stroke patients and 36 (12%) controls during follow-up, p=0.132. In multivariate Cox regression model, new-onset AF was associated only with heart failure (HR 3.2, 95%CI 1.27-8.00, p=0.014), Age≥65 years (HR 3.4, 95%CI 1.69-6.92, p=0.001) and male gender (HR 1.7, 95%CI 1.06-2.81, p=0.03). New-onset AF was predicted by CHADS2 ≥ 4 (HR 2.9, 95% CI 1.62-5.35, p < 0.001) or CHA2DS2-VASc ≥ 6 (HR 3.1 95%CI 1.37-7.19, p=0.007) scores.(Figure. Kaplan-Meier survival curv indicating new onset AF).
Conclusions: New onset AF during 10-year follow-up is not associated with previous ischemic stroke; however, high CHADS2 and CHA2DS2-VASc scores are predictive of AF occurrence. Patients with high cardiovascular risk profile may represent the target group which should be actively screened for AF, that may not be apparent at the time of stroke.
- © 2013 by American Heart Association, Inc.