Cardiovascular and Neurovascular Division, Department of Non-Communicable Diseases, Santé Publique France, Saint-Maurice, France (A.G., V.O.).
Department of Cardiology (C.G.), University Hospital of Dijon, France.
Stroke. 2021 Jun;52(6):2077-2085. doi: 10.1161/STROKEAHA.120.030812. Epub 2021 Apr 20.
Because of the aging population, an increase in the prevalence of atrial fibrillation (AF) is currently observed, thus leading to a rise in AF-related ischemic stroke (IS). We analyzed the current prevalence of AF among patients with IS, their characteristics, and temporal trends from 2006 to 2017 in the population-based Dijon Stroke Registry.
We used data from the Dijon Stroke Registry, an ongoing population-based study that records all cases of acute stroke among residents of the city of Dijon. All patients with IS between 2006 and 2017 were included. Previous AF was defined if it was mentioned in the medical file before stroke and newly diagnosed AF if it was diagnosed during the diagnostic workup of patients with acute stroke.
During the period 2014 to 2017, among the 796 patients with IS recorded in the Dijon Stroke Registry, 239 (30.0%) had AF, of whom 79 (9.9% of total patients with IS) had newly diagnosed AF, and 98 (12.3%) had previous AF treated with oral anticoagulants. Patients with IS with AF had more disabilities and a higher initial severity according to the National Institutes of Health Stroke Scale compared with those without AF. The age-adjusted prevalence of AF in patients with IS increased between 2006 and 2017 (+9% per time period), with an important increase in men aged 65 to 74 years (+81%) and women aged ≥85 years (+24%), and a significant decrease in women aged 65 to 74 years (−39%). The use of oral anticoagulant treatment in previous AF patients increased between 2006 and 2009 and 2014 and 2017 (29.3% to 61.3%, P<0.0001). However, 37.5% of patients with previous AF and CHADS2 score ≥2 were not treated with OAC.
The increase in AF prevalence in patients with IS could be related to a better diagnosis of this condition. The underuse of oral anticoagulation treatment was still observed.
由于人口老龄化，心房颤动（AF）的患病率目前正在上升，从而导致 AF 相关缺血性卒中（IS）的发病率上升。我们分析了 2006 年至 2017 年基于人群的第戎卒中登记处中 IS 患者的 AF 患病率、特征和时间趋势。
我们使用了第戎卒中登记处的数据，这是一项正在进行的基于人群的研究，记录了第戎市居民的所有急性卒中病例。纳入了 2006 年至 2017 年期间所有 IS 患者。如果在卒中前的病历中提到过 AF，则定义为既往 AF；如果在急性卒中患者的诊断性检查中诊断出 AF，则定义为新发 AF。
在 2014 年至 2017 年期间，在第戎卒中登记处记录的 796 例 IS 患者中，有 239 例（30.0%）患有 AF，其中 79 例（IS 患者总数的 9.9%）为新发 AF，98 例（12.3%）为接受口服抗凝剂治疗的既往 AF。与无 AF 的 IS 患者相比，AF 合并 IS 的患者残疾程度更高，初始严重程度更高，根据国立卫生研究院卒中量表评估。IS 患者的 AF 患病率在 2006 年至 2017 年期间进行了年龄调整，呈上升趋势（每个时间段增加 9%），65 至 74 岁的男性（+81%）和≥85 岁的女性（+24%）的增加幅度较大，65 至 74 岁的女性（-39%）的减少幅度较大。2006 年至 2009 年和 2014 年至 2017 年期间，既往 AF 患者中口服抗凝剂治疗的使用率有所增加（29.3%至 61.3%，P<0.0001）。然而，37.5%的既往 AF 且 CHADS2 评分≥2 的患者未接受 OAC 治疗。
IS 患者中 AF 患病率的增加可能与对此类疾病的诊断改善有关。口服抗凝剂治疗的使用率仍然较低。
