Frost Lars, Vukelic Andersen Ljubica, Godtfredsen John, Mortensen Leif Spange
Department of Cardiology A, Aarhus University Hospital, Aarhus, Denmark.
Neuroepidemiology. 2007;28(2):109-15. doi: 10.1159/000101509. Epub 2007 Apr 4.
Guidelines for the clinical management of patients with atrial fibrillation suggest that treatment strategies for prescribing oral anticoagulant therapy should implicate change at age 60, 65 and 75 years. We examined if there is any threshold concerning risk of stroke by age.
We identified 141,493 subjects, aged 40-89 years, with an incident hospital diagnosis of nonvalvular atrial fibrillation or flutter and no previous or concomitant diagnosis of stroke in the Danish National Registry of Patients from January 1, 1980, to December 31, 2002. The subjects were followed in the Danish National Registry of Patients for the occurrence of an incident diagnosis of stroke of any nature and in the Danish Civil Registration System for emigration and vital status. We examined the risk of stroke by age in men and women using Cox regression models, which included age categorized in intervals, linear splines of age with cut points at age 60 and 75 years, or at age 65 and 75 years. We also analyzed age as a continuous variable in linear and polynomial regression models.
During follow-up 15,964 incident strokes were reported to the Danish National Registry of Patients. The risk of stroke increased by increasing age at baseline. We did not find any evidence for a threshold concerning risk of stroke by age, and the best model fit was obtained in a third-order polynomial regression model.
The risk of stroke increased gradually by increasing age, and we could not detect any threshold concerning risk of stroke by age.
心房颤动患者的临床管理指南表明，口服抗凝治疗的处方策略应在60岁、65岁和75岁时有所改变。我们研究了是否存在按年龄划分的中风风险阈值。
我们从丹麦国家患者登记处识别出141493名年龄在40 - 89岁之间、首次住院诊断为非瓣膜性心房颤动或心房扑动且既往或同时无中风诊断的受试者，时间跨度为1980年1月1日至2002年12月31日。在丹麦国家患者登记处对这些受试者进行随访，以观察任何性质的中风的首次诊断情况，并在丹麦民事登记系统中跟踪其移民情况和生命状态。我们使用Cox回归模型按年龄分析男性和女性的中风风险，该模型包括按间隔分类的年龄、年龄的线性样条且在60岁和75岁或65岁和75岁处有切点，或者在线性和多项式回归模型中将年龄作为连续变量进行分析。
在随访期间，丹麦国家患者登记处报告了15964例首次中风病例。中风风险随基线年龄的增加而增加。我们没有发现按年龄划分的中风风险阈值的任何证据，并且在三阶多项式回归模型中获得了最佳的模型拟合。
中风风险随年龄增长而逐渐增加，并且我们未检测到按年龄划分的中风风险阈值。
