Department of Epidemiology and Prevention, Epidemiological Cardiology Research Center, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA.
Stroke. 2011 Oct;42(10):2950-3. doi: 10.1161/STROKEAHA.111.621367. Epub 2011 Aug 4.
We compared the associations of self-reported atrial fibrillation (AF) and ECG-detected AF with incident stroke in the Risk of Stroke in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.
In this analysis, 27 109 participants aged 45 years or older without previous stroke were included. Stroke cases were identified and adjudicated during an average of 4.4 years of follow-up. Cox proportional hazards analysis was used to calculate hazard ratios (HR) of self-reported AF, ECG-detected AF, and AF detected by either method with incident stroke. We also examined the predictive ability of the Framingham Stroke Risk Score (FSRS) when the component AF was defined by different methods.
After adjustment for components of the FSRS, self-reported AF, ECG-detected AF, and AF by either method were predictive of incident stroke (HR, 1.41; 95% CI, 1.05-1.88; HR, 1.90; 95% CI, 1.10-3.27; HR, 1.53; 95% CI, 1.16-2.01, respectively). When self-report, ECG, or either method, separately, were considered as the method of AF ascertainment in the FSRS, the HR per 1% increase in the FSRS were identical across AF ascertainment methods (HR, 1.04; 95% CI, 1.03-1.04; HR, 1.04; 95% CI, 1.04-1.05; HR, 1.04; 95% CI, 1.03-1.04; respectively).
Self-reported AF is a strong predictor of stroke that can be used interchangeably or in combination with ECG-detected AF in stroke risk prediction models.
我们比较了自述心房颤动（AF）和心电图检测到的 AF 与风险中的卒中事件的相关性卒中原因的地理和种族差异研究（REGARDS）。
在这项分析中，包括了 27109 名年龄在 45 岁或以上且无既往卒中的参与者。卒中病例在平均 4.4 年的随访期间确定并进行裁决。使用 Cox 比例风险分析计算自述 AF、心电图检测到的 AF 和通过任何一种方法检测到的 AF 与卒中事件的风险比（HR）。我们还检查了当 Framingham 卒中风险评分（FSRS）的 AF 成分由不同方法定义时，该评分的预测能力。
在调整 FSRS 成分后，自述 AF、心电图检测到的 AF 和任何一种方法检测到的 AF 均与卒中事件相关（HR，1.41；95%CI，1.05-1.88；HR，1.90；95%CI，1.10-3.27；HR，1.53；95%CI，1.16-2.01）。当自述、心电图或任何一种方法分别作为 FSRS 中 AF 确定的方法时，FSRS 每增加 1%的 HR 在 AF 确定方法之间相同（HR，1.04；95%CI，1.03-1.04；HR，1.04；95%CI，1.04-1.05；HR，1.04；95%CI，1.03-1.04）。
自述 AF 是卒中的一个强有力的预测因子，可以与心电图检测到的 AF 互换或组合使用，用于卒中风险预测模型。
