Differences in Stroke or Systemic Thromboembolism Readmission Risk After Hospitalization for Atrial Fibrillation and Atrial Flutter

Abstract

BackgroundAlthough atrial fibrillation (AF) and atrial flutter (AFL) are different arrhythmias, they are assumed to confer the same risk of stroke and systemic thromboembolism (STE) despite a lack of available evidence. In this study, we investigated the difference in the risk of stroke or STE after AF and AFL hospitalizations. MethodologyThe National Readmission Database (NRD) 2018 was used to identify AF and AFL patients using appropriate International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes and were followed until the end of the calendar year to identify stroke or STE readmissions. Survival estimates were calculated, and a Cox proportional hazards model was used to calculate the adjusted hazards ratio (aHR) and compare the risk of stroke or STE readmissions between AF and AFL groups. ResultsA total of 215,810 AF and 15,292 AFL patients were identified. AFL patients were more likely to be younger (66 vs. 70 years), male (68% vs. 47%), and had higher prevalence of obesity (25% vs. 22%), obstructive sleep apnea (14% vs. 12%), diabetes mellitus (31% vs. 26%), and alcohol use (6.9% vs. 5.5%) (all p < 0.01). After adjusting for potential patient and hospital-level characteristics, there was a statistically significant decrease in one-year stroke or STE readmission risk in AFL patients compared to AF patients (aHR 0.79 (0.66-0.95); p = 0.01). ConclusionsAFL patients are commonly younger males with a higher burden of medical comorbidity. There is a decrease in the one-year risk of stroke or STE events in AFL patients compared to AF. The predictors of stroke and STE are similar in both AFL and AF groups. Further studies with longer follow-up and anticoagulation data are needed to verify the results.

Sex differences in outcomes after endovascular treatment of patients with vertebrobasilar artery occlusion

“…8,9 Due to atrial fibrillation, women are more susceptible to thromboembolic events, particularly cardioembolic strokes. 10…”

“…8,9 Due to atrial fibrillation, women are more susceptible to thromboembolic events, particularly cardioembolic strokes. 10 There is growing knowledge in many stroke areas, however, in the field of EVT, especially in VBAO patients, knowledge about sex differences is limited. In addition, VBAO patients have atypical onset symptoms, untimely recognition of symptoms, increased likelihood of stroke mimics, delayed acute imaging, and a longer time interval between symptom onset and consultation and initiation of treatment.…”