Long-term occurrence of death and cardiovascular events in patients with transient ischaemic attack or minor ischaemic stroke: comparison between arterial and cardiac source of the index event

Wijk, Iris van; Koudstaal, Peter J.; Kappelle, L. Jaap; Gijn, J. van; Gorter, J. W.; Algra, Ale

doi:10.1136/jnnp.2007.133132

Cited by 15 publications

(9 citation statements)

References 24 publications

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“…The overall increased short- and long-term mortality among patients with atrial fibrillation in our study is consistent with a number of other studies 4–11,44. Different mechanisms have been suggested to underlie the increased mortality, yet no definitive answer has emerged.…”

Section: Discussionsupporting

confidence: 88%

Atrial fibrillation in patients with ischemic stroke: A population-based study

Thygesen¹,

Frost²,

Eagle³

2009

CLEP

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Background:Atrial fibrillation is a major risk factor for ischemic stroke. However, the prognostic impact of atrial fibrillation among patients with stroke is not fully clarified. We compared patient characteristics, including severity of stroke and comorbidity, quality of in-hospital care and outcomes in a cohort of first-time ischemic stroke patients with and without atrial fibrillation.Methods:Based on linkage of public medical databases, we did a population-based follow-up study among 3,849 stroke patients from the County of Aarhus, Denmark admitted in the period of 2003–2007 and prospectively registered in the Danish National Indicator Project.Results:Atrial fibrillation was associated with an adverse prognostic profile but not with an overall poorer quality of in-hospital care. Patients with atrial fibrillation had a longer total length of stay (median: 15 vs 9 days), and were at increased risk of in-hospital medical complications (adjusted relative risk = 1.48, 95% CI: 1.23–1.79) and recurrent stroke (adjusted hazard ratio = 1.30, 95% CI: 0.93–1.82) when compared with patients without atrial fibrillation. The adjusted hazard ratios for 30 days and one year mortality were 1.55 (95% CI: 1.20–2.01) and 1.55 (95% CI: 1.30–1.85), respectively. Patients not eligible to oral anticoagulant treatment had an increased risk of recurrent stroke (adjusted hazard ratio = 1.92, 95% CI: 1.19–3.11).Conclusion:Atrial fibrillation is associated with a poor outcome among patients with ischemic stroke particularly among patients, who are not eligible to oral anticoagulant treatment.

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Section: Discussionsupporting

confidence: 88%

Atrial fibrillation in patients with ischemic stroke: A population-based study

Thygesen¹,

Frost²,

Eagle³

2009

CLEP

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“…In the Dutch TIA Trial [26] 60% had died after 10 years, while in the present study 74% of participants with ischemic stroke had died at 10 years, which reflects that our sample was population-based and also included the severest stroke patients, while the Dutch population consisted of patients with TIAs and minor stroke.…”

Section: Discussionmentioning

confidence: 81%

Long-Term Survival after Stroke: 30 Years of Follow-Up in a Cohort, the Copenhagen City Heart Study

Boysen¹,

Marott

Grønbæk³

et al. 2009

Neuroepidemiology

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Background and Purpose: Only few have studied long-term survival after stroke. Such knowledge is essential for the evaluation of the current and future burden of stroke. The present study presents up to 30 years of follow-up of patients after a first-ever stroke. Methods: Participants in the Copenhagen City Heart Study who experienced a first-ever stroke from 1978 to the end of 2001 were followed to the end of 2007. Stroke events were validated using the World Health Organization’s definition of stroke. Linkage to the Danish Civil Registration System enabled identification of participants who died before the end of 2007. The National Register of Causes of Death provided cause of death. Survival in stroke patients was compared with survival in participants in the Copenhagen City Heart Study who did not suffer a stroke, and with survival in the general Danish population. Cox regression analyses adjusting for age and gender were used to compare survival in six consecutive 4-year periods starting with 1978–1982. Results: Of 2,051 patients with first-ever stroke 1,801 died during follow-up. Causes of death were cerebrovascular disease in 37%, other cardiovascular diseases in 28%, cancer in 12%, and other causes in 23%. The most important determinant for long-term survival was age at time of stroke. In the 65- to 72-year age group 11% survived 15 years after stroke. In the age group <65 years 28% survived 15 years. For all age groups survival was poorer in stroke patients than in non-stroke controls. Long-term survival improved steadily over time. Life expectancy after stroke increased up to 4 years from 1978 to the end of 2001, exceeding the increase of life expectancy in the general population. Slightly longer survival was found in women than in men when adjusted for age at stroke onset. Conclusion: In this cohort long-term survival after stroke gradually improved over three decades from 1978. The gain in remaining lifetime after stroke exceeded that of the general population.

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“…Some authors have shown that a recent infarct on CT scan increases significantly the 90-day risk of stroke [14]. Other factors such as atrial fibrillation [15] and the type of stroke [13] were implied in an increased risk. About this latter point atherosclerotic seems to carry a substantial risk of stroke [13].…”

Section: Introductionmentioning

confidence: 97%

Carotid stenosis as predictor of stroke after transient ischemic attacks

Bonifati,

Lorenzi,

Ermani

et al. 2011

Journal of the Neurological Sciences

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Long-term occurrence of death and cardiovascular events in patients with transient ischaemic attack or minor ischaemic stroke: comparison between arterial and cardiac source of the index event

Abstract: Our study shows that the long term risk of death or vascular events is 1.5 times higher in patients with CIAF than in those with CIAO, after adjustment for differences between the groups.

Cited by 15 publications

References 24 publications

Atrial fibrillation in patients with ischemic stroke: A population-based study

Atrial fibrillation in patients with ischemic stroke: A population-based study

Long-Term Survival after Stroke: 30 Years of Follow-Up in a Cohort, the Copenhagen City Heart Study

Carotid stenosis as predictor of stroke after transient ischemic attacks

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