Epidemiology of ischemic stroke from atrial fibrillation in Dijon, France, from 1985 to 2006

Béjot, Yannick; Salem, Douraı̈ed Ben; Osseby, Guy Victor; Couvreur, G.; Durier, Jérôme; Marie, Christine; Cottin, Yves; Moreau, Thibault; Giroud, Maurice

doi:10.1212/01.wnl.0000341280.31919.bd

Cited by 66 publications

(75 citation statements)

References 31 publications

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“…As the prevalence of AF increases, due partly to the aging population 6 , we would expect more AF-related CE strokes in the future 7 . The Global Burden of Diseases Study Group showed that, from 1990 to 2013, 75% of deaths from strokes and 81% of the stroke-related disability-adjusted life years lost occur in lowand middle-income countries 8 , where the progressive economic pressure of the growing elderly population is occurring 9 .…”

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confidence: 99%

Incidence and functional outcome of atrial fibrillation and non-atrial fibrillation- related cardioembolic stroke in Joinville, Brazil: a population-based study

Amaral

Nagel³

et al. 2017

Arq. Neuro-Psiquiatr.

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Among ischemic strokes, cardioembolic (CE) stroke has the worst outcome. We measured the incidence of atrial fibrillation (AF) and non-AF related CE strokes, previous anticoagulant use, and the 90-day functional outcome. Using multiple overlapping sources, we included all CE strokes that occurred in 2015 in Joinville, Brazil. Of the 374 ischemic strokes, 23% (84) were CE. The CE age-adjusted incidence, per 1,000 person-years, was 0.14 (0.11-0.17). Of the 26 patients with known prior AF, 73% (19) were not anticoagulated, 77% (20) had a CHA 2 DS 2 VASc score ≥ 3 and 81% (21) had a HAS-BLED score < 3. After three months, approximately one third of those 26 patients died or became disabled. The incidence of CE stroke in our sample was lower than in other population-based studies. The opportunity for anticoagulation was missed in one third of cases.Keywords: stroke; incidence; prognosis; population studies in public health. RESUMOEntre todos os subtipos de AVC isquêmico, os eventos cardioembólicos (CE) apresentam os piores prognósticos. Determinamos a incidência de AVC isquêmico CE, associada ou não à fibrilação atrial (FA), o uso prévio de anticoagulantes e os desfechos funcionais em Joinville, Brasil. Utilizando múltiplas e sobrepostas fontes de informação, registramos todos os primeiros eventos CE ocorridos em 2015. Entre 374 eventos isquêmicos, 23% (84) foram CE. A incidência ajustada, para qualquer fonte cardioembólica, foi 0.14 (0.11-0.17) por 1000 pessoas-ano. Entre 26 pacientes com FA previamente conhecida, 73% (19) não estavam anticoagulados, 77% (20) tinham ≥ 3 pontos na escala CHA 2 DS 2 VASc e 81 % (21) < 3 pontos na escala HAS-BLED. Após 3 meses, um terço destes 26 pacientes morreram ou ficaram dependentes. A incidência de AVC I CE em Joinville é menor do que em outros estudos de base populacional. Um terço dos casos de AVC I CE com FA previamente conhecida perderam a oportunidade de anticoagulação.Palavras-chave: acidente cerebral vascular; incidência; prognóstico; estudos populacionais em saúde pública.Worldwide, ischemic stroke is the most common major pathological type of stroke 1 . Among all ischemic stroke subtypes, cardioembolic (CE) stroke is particularly worrisome for two main reasons. The first one is demographic: as age is a risk factor for both atrial fibrillation (AF) and stroke, the aging of the population will progressively increase the burden of CE stroke in many countries.1,2 The second reason involves outcomes: in a population-based study in Oxfordshire, UK, 2,555 ischemic stroke subtypes were followed up from 2002 to 2014. After six months, two thirds were dependent. After one year, 42% had died. These outcomes are significantly higher than those reported for other ischemic stroke subtypes 2 . Therefore, knowing the incidence of CE stroke is crucial for primary and secondary prevention policies 1,2,3 .

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Incidence and functional outcome of atrial fibrillation and non-atrial fibrillation- related cardioembolic stroke in Joinville, Brazil: a population-based study

Amaral

Nagel³

et al. 2017

Arq. Neuro-Psiquiatr.

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“…[1][2][3] Chronic atrial fibrillation increases stroke risk 5-to 17-fold, [4][5][6] and patients with paroxysmal atrial fibrillation may have a similar prognosis. 7,8 In the latter group, the 2006 American Heart Association guidelines conclude that rhythm control using direct-current cardioversion (DCCV) is an acceptable strategy to restore sinus rhythm.…”

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confidence: 99%

Thirty‐day Outcomes of Emergency Department Patients Undergoing Electrical Cardioversion for Atrial Fibrillation or Flutter

Scheuermeyer

Grafstein

Stenstrom

et al. 2010

Academic Emergency Medicine

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Objectives: While the short-term (<7-day) safety and efficiency of electrical cardioversion for emergency department (ED) patients with atrial fibrillation or flutter have been established, the 30-day outcomes with respect to stroke, thromboembolic events, or death have not been investigated.Methods: A two-center cohort of consecutive ED patients undergoing cardioversion for atrial fibrillation or flutter between January 1, 2000, and September 30, 2007, was retrospectively investigated. This cohort was probabilistically linked with both a regional ED database and the provincial health registry to determine which patients had a subsequent ED visit or hospital admission, stroke, or thromboembolic event or died within 30 days. In addition, trained reviewers performed a detailed chart abstraction on 150 randomly selected patients, with emphasis on demographics, vital signs, medical treatment, and predefined adverse events. Hemodynamically unstable patients or those whose condition was the result of an underlying acute medical diagnosis were excluded. Data were analyzed by descriptive methods.Results: During the study period, 1,233 patients made 1,820 visits for atrial fibrillation or flutter to the ED. Of the 400 eligible patients undergoing direct-current cardioversion (DCCV), no patients died, had a stroke, or had a thromboembolic event in the following 30 days (95% confidence interval [CI] = 0.0 to 0.8% for all outcomes). A total of 141 patients were included in the formal chart review, with five patients (3.5%, 95% CI = 0.5% to 6.6%) failing cardioversion, six patients (4.3%, 95% CI = 0.9% to 7.6%) having a minor adverse event that did not change disposition, and five patients (3.5%, 95% CI = 0.5% to 6.6%) admitted to hospital at the index visit.Conclusions: Cardioversion of patients with atrial fibrillation or flutter in the ED appears to have a very low rate of long-term complications.ACADEMIC EMERGENCY MEDICINE 2010; 17:408-415 ª

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“…5 Hipertensi merupakan salah satu faktor risiko terjadinya stroke iskemik. 6 Sekitar 70% hingga 94% pasien stroke akut mengalami peningkatan tekanan darah sistolik hingga di atas 140 mmHg. 4 Hasil penelitian sebelumnya menunjukkan bahwa terdapat sekitar 73,9% pasien stroke akut yang mengalami hipertensi di Indonesia, dan 22,5-27,6% di antaranya mengalami peningkatan tekanan darah sistolik di atas 180 mmHg.…”

Section: Pendahuluanunclassified

“…3,11 Tekanan darah akan meningkat seiring dengan bertambahnya usia, sebab arteri secara perlahan kehilangan elastisitasnya. 6 Terjadinya stroke pada rentang usia ini juga dapat disebabkan oleh beberapa kondisi medis, di antaranya tekanan darah tinggi, diabetes, kelainan pembuluh darah atau jantung, dan migrain. Faktor hidup yang tidak sehat, seperti konsumsi rokok dan alkohol, juga diketahui dapat meningkatkan risiko terjadinya stroke pada kelompok usia ini.…”

Section: Hasilunclassified

“…Faktor hidup yang tidak sehat, seperti konsumsi rokok dan alkohol, juga diketahui dapat meningkatkan risiko terjadinya stroke pada kelompok usia ini. 4,6,15 Penggunaan terapi antihipertensi di RSSN Bukittinggi 100% tepat indikasi (Tabel 2), yang artinya pemberian antihipertensi pada pasien stroke iskemik ini telah sesuai dengan indikasi yang seharusnya menurut standar/ Jurnal Farmasi Klinik Indonesia Volume 7, Nomor 2, Juni 2018 kriteria yang telah ditetapkan. Antihipertensi merupakan salah satu obat yang diberikan pada penanganan pasien stroke iskemik dengan hipertensi.…”

Section: Hasilunclassified

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Evaluation of Antihypertensive Drug Use on Ischemic Stroke Patients at National Stroke Hospital Bukittinggi

Juwita

Almasdy

Hardini

2018

Indones J Clin Pharm

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AbstrakObat antihipertensi menjadi salah satu obat yang paling banyak diresepkan pada pasien stroke iskemik. Penatalaksanaan hipertensi yang tidak tepat pada kedaruratan neurovaskular akut dapat meningkatkan risiko kerusakan otak dan saraf. Penggunaan obat antihipertensi harus dievaluasi melalui program evaluasi penggunaan obat (EPO) untuk menjamin penggunaan obat yang rasional. Penelitian ini bertujuan untuk mengkaji kerasionalan/ketepatan penggunaan obat antihipertensi pada pasien stroke iskemik meliputi tepat indikasi, tepat obat, tepat regimen dosis dan tepat pasien. Penelitian ini merupakan penelitian deskriptif retrospektif dengan menggunakan data rekam medis 150 pasien stroke iskemik. Kriteria inklusi penelitian yaitu semua pasien stroke iskemik nonkardioemboli dan tanpa komplikasi yang menerima terapi antihipertensi di Instalasi Rawat Inap (IRNA) Rumah Sakit Stroke Nasional (RSSN) Bukittinggi pada tahun 2016. Evaluasi ketepatan dilakukan secara deskriptif dengan membandingkan data penelitian terhadap literatur. Hasil penelitian menunjukkan ketepatan penggunaan obat antihipertensi yaitu 100% tepat indikasi; 84% tepat obat; 96% tepat dosis; 98% tepat frekuensi; dan 100% tepat pasien. Jenis ketidaktepatan yang paling sering ditemui adalah ketidaktepatan kombinasi obat serta ketidaksesuaian pemilihan obat dengan stage hipertensi yang diderita pasien. Dibutuhkan peran apoteker rumah sakit sebagai bagian dari upaya peningkatan ketepatan penggunaan obat pada pasien stroke.Kata kunci: Antihipertensi, evaluasi penggunaan obat, stroke iskemik, tepat dosis, tepat indikasi, tepat obat Evaluation of Antihypertensive Drug Use on Ischemic Stroke Patients at National Stroke Hospital Bukittinggi AbstractAntihypertensive drugs are the most widely prescribed drug for ischemic stroke patients. Inappropriate management of hypertension in acute neurovascular emergencies may increase the risk of brain and nerve damage. Use of antihypertensive drugs should be evaluated through a drug use evaluation program to ensure rational use of drugs. This study aimed to examine the rationale for the use of antihypertensive drugs in patients with ischemic stroke including indications, drugs, dosage regimens and patients. This research was a retrospective descriptive study using medical record data of 150 ischemic stroke patients who met the inclusion criteria, i.e. all non-cardioembolic and uncomplicated ischemic stroke patients receiving antihypertensive therapy in Inpatient Care (IRNA of National Stroke Hospital Bukittinggi (RSSN) in 2016. The evaluation of accuracy was done descriptively by comparing the research data with the literature. The results showed that 100% of medication use was precisely indicated; 84% precise medication; 96% right dose; 98% exact frequency; and 100% precise patient. Inappropriate drug selection compared to the stage of hypertension and incorrect drug combinations were the most common types of inappropriate medications found in this study inaccuracies. It takes the role of hospital pharmacists as part of effor...

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Epidemiology of ischemic stroke from atrial fibrillation in Dijon, France, from 1985 to 2006

Cited by 66 publications

References 31 publications

Incidence and functional outcome of atrial fibrillation and non-atrial fibrillation- related cardioembolic stroke in Joinville, Brazil: a population-based study

Incidence and functional outcome of atrial fibrillation and non-atrial fibrillation- related cardioembolic stroke in Joinville, Brazil: a population-based study

Thirty‐day Outcomes of Emergency Department Patients Undergoing Electrical Cardioversion for Atrial Fibrillation or Flutter

Evaluation of Antihypertensive Drug Use on Ischemic Stroke Patients at National Stroke Hospital Bukittinggi

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