Abstract 14242: Clinical Impact of Previous Ischemic or Hemorrhagic Stroke on the Intracranial Event in Japanese Patients With Atrial Fibrillation: The Fushimi AF Registry
Introduction: Little is known about the risk factors for each of ischemic and hemorrhagic stroke in patients with atrial fibrillation (AF).
Methods: The Fushimi AF Registry, a community-based survey, was designed to enroll all of the AF patients who visited the participating institutions in Fushimi-ku, Kyoto, Japan. Follow-up data were available for 3,499 patients by April 2015 (median follow-up period: 849 days). We explored the predictors for each of ischemic and hemorrhagic stroke, especially focusing on previous ischemic or hemorrhagic stroke.
Results: The mean age was 73.6±10.9 years. The mean CHADS2, CHA2DS2-VASc and HAS-BLED scores were 2.01, 3.35 and 1.49, respectively. 53.5% of patients received oral anticoagulation (OAC) at baseline. Ischemic stroke occurred in 132 patients (3.8%) and hemorrhagic stroke in 42 (1.2%). On multivariate analysis, the independent predictors for ischemic stroke were as follows: advanced age (≥75 years) (hazard ratio [HR]: 2.37, 95% confidence interval [CI]: 1.63-3.53), sustained (persistent or permanent) AF (HR: 1.51, 95% CI: 1.05-2.23) and previous ischemic stroke (HR: 2.23, 95% CI: 1.54-3.19). As for hemorrhagic stroke, the independent predictor was previous hemorrhagic stroke (HR: 4.96, 95% CI: 1.19-13.8), whereas either of hypertension, previous ischemic stroke or OAC prescription was not.
In patients with versus without previous ischemic stroke, the annual incidence of ischemic stroke was higher (3.55% vs. 1.35%; p<0.01), but that of hemorrhagic stroke was similar (0.58% vs. 0.53%; p=0.81). This was also the case with patients with versus without previous hemorrhagic stroke; the incidence of hemorrhagic stroke was higher (2.67% vs. 0.51%; p<0.01), and that of ischemic stroke was similar (1.78% vs. 1.73%; p=0.99) (Figure).
Conclusions: The risk of stroke in patients with AF was dependent on the type of stroke. The history of ischemic or hemorrhagic stroke was a risk of the same type of stroke, but not of the other one.
Author Disclosures: Y. An: None. M. Ishii: None. T. Unoki: None. M. Iguchi: None. N. Masunaga: None. H. Ogawa: None. H. Wada: None. K. Hasegawa: None. M. Esato: None. Y. Chun: None. M. Abe: None. M. Akao: Research Grant; Modest; Boehringer Ingelheim, Bayer, Daiichi-Sankyo, Takeda Pharmaceutical. Speakers Bureau; Modest; Pfizer, Daiichi-Sankyo, Tanabe-Mitsubishi. Speakers Bureau; Significant; Bristol-Myers Squibb, Boehringer Ingelheim, Bayer.
- © 2015 by American Heart Association, Inc.