Risk of ischaemic stroke according to pattern of atrial fibrillation: Analysis of 6563 aspirin-treated patients in active-a and averroes

European Heart Journal

Volumn 36, Issue 5, 2015, Pages 281-287

  Vanassche, Thomas ^a   Lauw, Mandy N ^a   Eikelboom, John W ^a   Healey, Jeff S ^a   Hart, Robert G ^a   Alings, Marco ^b   Avezum, Alvaro ^c   Díaz, Rafael ^d   Hohnloser, Stefan H ^e   Lewis, Basil S ^f   Shestakovska, Olga ^a   Wang, Jia ^a   Connolly, Stuart J ^a  

^a HAMILTON HEALTH SCIENCES   (Canada)

^b AMPHIA HOSPITAL   (Netherlands)

^c INSTITUTO DANTE PAZZANESE DE CARDIOLOGIA   (Brazil)

^d Estudios Clinícos Latinoamérica ^*  (Argentina)

^e GOETHE UNIVERSITY   (Germany)

^f TECHNION ISRAEL INSTITUTE OF TECHNOLOGY   (Israel)

Author keywords

Atrial fibrillation; Paroxysmal; Permanent; Stroke

Indexed keywords

ACETYLSALICYLIC ACID; AMIODARONE; APIXABAN; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CLOPIDOGREL; DIGOXIN; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; FIBRINOLYTIC AGENT;

AGED; ARTICLE; ATRIAL FIBRILLATION; BRAIN ISCHEMIA; CEREBROVASCULAR ACCIDENT; CORONARY ARTERY DISEASE; DIABETES MELLITUS; ELECTROCARDIOGRAM; EMBOLISM; FEMALE; HAZARD RATIO; HEART FAILURE; HEART LEFT VENTRICLE EJECTION FRACTION; HUMAN; HYPERTENSION; MAJOR CLINICAL STUDY; MALE; MULTICENTER STUDY (TOPIC); PAROXYSMAL ATRIAL FIBRILLATION; PERIPHERAL VASCULAR DISEASE; PERMANENT ATRIAL FIBRILLATION; PERSISTENT ATRIAL FIBRILLATION; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); RISK FACTOR; SINUS RHYTHM; TRANSIENT ISCHEMIC ATTACK; CLINICAL TRIAL; COMPLICATION; CONTROLLED STUDY; DOUBLE BLIND PROCEDURE; KAPLAN MEIER METHOD; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; SEX RATIO; STROKE;

AGED; ASPIRIN; ATRIAL FIBRILLATION; BRAIN ISCHEMIA; DOUBLE-BLIND METHOD; EMBOLISM; FEMALE; FIBRINOLYTIC AGENTS; HUMANS; KAPLAN-MEIER ESTIMATE; MALE; RISK FACTORS; SEX DISTRIBUTION; STROKE;

EID: 84928403462     PISSN: 0195668X     EISSN: 15229645     Source Type: Journal    
DOI: 10.1093/eurheartj/ehu307     Document Type: Article

References (42)

1. Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007; 146:857-867.
2. Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD, Camm AJ,Weitz JI, Lewis BS, Parkhomenko A, Yamashita T, Antman EM. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 2014;383:955-962.
3. The Atrial Fibrillation Investigators. The efficacy of aspirin in patients with atrial fibrillation. Analysis of pooled data from 3 randomized trials. Arch Intern Med 1997;157: 1237-1240.
4. Gage BF,Waterman AD, ShannonW, Boechler M, RichMW, Radford MJ. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA 2001;285:2864-2870.
5. Hart RG, Pearce LA, McBride R, Rothbart RM, AsingerRW. Factors associated with ischemic stroke during aspirin therapy in atrial fibrillation: analysis of 2012 participants in the SPAF I-III clinical trials. The Stroke Prevention in Atrial Fibrillation (SPAF) Investigators. Stroke 1999;30:1223-1229.
6. Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest 2010;137: 263-272.
7. Wang TJ, Massaro JM, Levy D, Vasan RS, Wolf PA, D'Agostino RB, Larson MG, Kannel WB, Benjamin EJ. A risk score for predicting stroke or death in individuals with new-onset atrial fibrillation in the community: the Framingham Heart Study. JAMA 2003;290:1049-1056.
8. Flegel KM, Hanley J. Risk factors for stroke and other embolic events in patients with nonrheumatic atrial fibrillation. Stroke 1989;20:1000-1004.
9. Stroke Risk in Atrial FibrillationWorking Group. Independent predictors of stroke in patients with atrial fibrillation: a systematic review. Neurology 2007;69:546-554.
10. Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, Van Gelder IC, Al-Attar N, Hindricks G, Prendergast B, Heidbuchel H, Alfieri O, Angelini A, Atar D, Colonna P, De Caterina R, De Sutter J, Goette A, Gorenek B, Heldal M, Hohloser SH, Kolh P, Le Heuzey JY, Ponikowski P, Rutten FH. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J 2010;31:2369-2429.
11. Petersen P, Godtfredsen J. Embolic complications in paroxysmal atrial fibrillation. Stroke 1986;17:622-626.
12. Roy D, Marchand E, Gagne P, Chabot M, Cartier R. Usefulness of anticoagulant therapy in the prevention of embolic complications of atrial fibrillation. Am Heart J 1986;112:1039-1043.
13. Treseder AS, Sastry BS, Thomas TP, YatesMA, Pathy MS. Atrial fibrillation and stroke in elderly hospitalized patients. Age Ageing 1986;15:89-92.
14. Hart RG, Pearce LA, Rothbart RM, McAnulty JH, Asinger RW, Halperin JL. Stroke with intermittent atrial fibrillation: incidence and predictors during aspirin therapy. Stroke Prevention in Atrial Fibrillation Investigators. J Am Coll Cardiol 2000;35: 183-187.
15. Scardi S, Mazzone C, Pandullo C, Goldstein D, Poletti A, Humar F. Lone atrial fibrillation: prognostic differences between paroxysmal and chronic forms after 10 years of follow-up. Am Heart J 1999;137(4 Pt 1):686-691.
16. Hohnloser SH, Pajitnev D, Pogue J, Healey JS, Pfeffer MA, Yusuf S, Connolly SJ. Incidence of stroke in paroxysmal versus sustained atrial fibrillation in patients taking oral anticoagulation or combined antiplatelet therapy: an ACTIVE W Substudy. J Am Coll Cardiol 2007;50:2156-2161.
17. Lip GY, Frison L, Grind M, SPORTIF Investigators. Stroke event rates in anticoagulated patients with paroxysmal atrial fibrillation. J Intern Med 2008;264:50-61.
18. Nieuwlaat R, Dinh T, Olsson SB, Camm AJ, Capucci A, Tieleman RG, Lip GY, Crijns HJ, Euro Heart Survey Investigators. Shouldweabandon thecommon practice of withholding oral anticoagulation in paroxysmal atrial fibrillation?. Eur Heart J 2008; 29:915-922.
19. Ruigomez A, Johansson S,Wallander MA, Edvardsson N, Garcia Rodriguez LA. Risk of cardiovascular and cerebrovascular events after atrial fibrillation diagnosis. Int J Cardiol 2009;136:186-192.
20. Friberg L, Hammar N, Rosenqvist M. Stroke in paroxysmal atrial fibrillation: report from the Stockholm Cohort of Atrial Fibrillation. Eur Heart J 2010;31:967-975.
21. Chiang CE, Naditch-Brule L, Murin J, Goethals M, Inoue H, O'Neill J, Silva-Cardoso J, Zharinov O, Gamra H, Alam S, Ponikowski P, LewalterT, Rosenqvist M, Steg PG. Distribution and risk profile of paroxysmal, persistent, and permanent atrial fibrillation in routine clinical practice: insight from the real-life global survey evaluating patients with atrial fibrillation international registry. Circ Arrhythm Electrophysiol 2012;5: 632-639.
22. Flaker G, Ezekowitz M, Yusuf S, Wallentin L, Noack H, Brueckmann M, Reilly P, Hohnloser SH, Connolly S. Efficacy and safety of dabigatran compared to warfarin in patients with paroxysmal, persistent, and permanent atrial fibrillation: results from the RE-LY (Randomized Evaluation of Long-Term Anticoagulation Therapy) study. J Am Coll Cardiol 2012;59:854-855.
23. Al-Khatib SM, Thomas L, Wallentin L, Lopes RD, Gersh B, Garcia D, Ezekowitz J, Alings M, Yang H, Alexander JH, Flaker G, Hanna M, Granger CB. Outcomes of apixaban vs. warfarin by type and duration of atrial fibrillation: results from the ARISTOTLE trial. Eur Heart J 2013;34:2464-2471.
24. Banerjee A, Taillandier S, Olesen JB, Lane DA, Lallemand B, Lip GY, Fauchier L. Pattern of atrial fibrillation and risk of outcomes: the Loire Valley Atrial Fibrillation Project. Int J Cardiol 2013;167:2682-2687.
25. Disertori M, Franzosi MG, Barlera S, Cosmi F, Quintarelli S, Favero C, Cappellini G, Fabbri G, Maggioni AP, Staszewsky L, Moroni LA, Latini R, investigators G-A. Thromboembolic event rate in paroxysmal and persistent atrial fibrillation: data from the GISSI-AF trial. BMC Cardiovasc Disord 2013;13:28.
26. The Boston Area Anticoagulation Trial for Atrial Fibrillation Investigators. The effect of low-dose warfarin on the risk of stroke in patients with nonrheumatic atrial fibrillation. N Engl J Med 1990;323:1505-1511.
27. Patel MR, Mahaffey KW, Garg J, Pan G, Singer DE, Hacke W, Breithardt G, Halperin JL, Hankey GJ, Piccini JP, Becker RC, Nessel CC, Paolini JF, Berkowitz SD, Fox KA, Califf RM. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011;365:883-891.
28. Connolly S, Yusuf S, Budaj A, Camm J, Chrolavicius S, Commerford PJ, Flather M, Fox KA, Hart R, Hohnloser S, Joyner C, Pfeffer M, Anand I, Arthur H, Avezum A, Bethala-Sithya M, Blumenthal M, Ceremuzynski L, De Caterina R, Diaz R, Flaker G, Frangin G, Franzosi MG, Gaudin C, Golitsyn S, Goldhaber S, Granger C, Halon D, Hermosillo A, Hunt D, Jansky P, Karatzas N, Keltai M, Lanas F, Lau CP, Le Heuzey JY, Lewis BS, Morais J, Morillo C, Oto A, Paolasso E, Peters RJ, Pfisterer M, Piegas L, Pipillis T, Proste C, Sitkei E, Swedberg K, Synhorst D, Talajic M, Tregou V, Valentin V, van MieghemW,WeintraubW, Varigos J. Rationale and design of ACTIVE: the atrial fibrillation clopidogrel trial with irbesartan for prevention of vascular events. Am Heart J 2006;151:1187-1193.
29. Eikelboom JW, O'Donnell M, Yusuf S, Diaz R, Flaker G, Hart R, Hohnloser S, Joyner C, Lawrence J, Pais P, Pogue J, Synhorst D, Connolly SJ. Rationale and design of AVERROES: apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin K antagonist treatment. Am Heart J 2010;159:348-353 e1.
30. Giugliano RP, Ruff CT, Braunwald E, Murphy SA, Wiviott SD, Halperin JL,Waldo AL, Ezekowitz MD,Weitz JI, Spinar J, RuzylloW, Ruda M, Koretsune Y, Betcher J, Shi M, Grip LT, Patel SP, Patel I, Hanyok JJ, Mercuri M, Antman EM. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2013;369:2093-2104.
31. Kannel WB, Abbott RD, Savage DD, McNamara PM. Epidemiologic features of chronic atrial fibrillation: the Framingham study. NEngl J Med 1982;306:1018-1022.
32. Fatkin D, Kelly RP, Feneley MP. Relations between left atrial appendage blood flow velocity, spontaneous echocardiographic contrast and thromboembolic risk in vivo. J Am Coll Cardiol 1994;23:961-969.
33. Gupta DK, Shah AM, Giugliano RP, Ruff CT, Antman EM, Grip LT, Deenadayalu N, Hoffman E, Patel I, Shi M, Mercuri M, Mitrovic V, Braunwald E, Solomon SD. Left atrial structure and function in atrial fibrillation: ENGAGE AF-TIMI 48. Eur Heart J 2014;35:1457-1465.
34. Platonov PG, Mitrofanova LB, Orshanskaya V, Ho SY. Structural abnormalities in atrial walls are associated with presence and persistency of atrial fibrillation but not with age. J Am Coll Cardiol 2011;58:2225-2232.
35. Hijazi Z, Oldgren J, Andersson U, Connolly SJ, Ezekowitz MD, Hohnloser SH, Reilly PA, Vinereanu D, Siegbahn A, Yusuf S, Wallentin L. Cardiac biomarkers are associated with an increased risk of strokeand death in patients with atrial fibrillation: a Randomized Evaluation of Long-term Anticoagulation Therapy (RE-LY) substudy. Circulation 2012;125:1605-1616.
36. Hijazi Z, Oldgren J, Siegbahn A, Granger CB,Wallentin L. Biomarkers in atrial fibrillation: a clinical review. Eur Heart J 2013;34:1475-1480.
37. Lip GY, Lowe GD, Rumley A, Dunn FG. Fibrinogen and fibrin D-dimer levels in paroxysmal atrial fibrillation: evidence for intermediate elevated levels of intravascular thrombogenesis. Am Heart J 1996;131:724-730.
38. de Vos CB, Pisters R, Nieuwlaat R, Prins MH, Tieleman RG, Coelen RJ, van den Heijkant AC, Allessie MA, Crijns HJ. Progression from paroxysmal to persistent atrial fibrillation clinical correlates and prognosis. J Am Coll Cardiol 2010;55: 725-731.
39. Healey JS, Connolly SJ, Gold MR, IsraelCW, Van Gelder IC, Capucci A, LauCP, Fain E, Yang S, Bailleul C, Morillo CA, Carlson M, Themeles E, Kaufman ES, Hohnloser SH. Subclinical atrial fibrillation and the risk of stroke. N Engl J Med 2012;366:120-129.
40. Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, Pogue J, Reilly PA, Themeles E, Varrone J, Wang S, Alings M, Xavier D, Zhu J, Diaz R, Lewis BS, Darius H, Diener HC, Joyner CD,Wallentin L. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009;361:1139-1151.
41. Granger CB, Alexander JH, McMurray JJ, Lopes RD, Hylek EM, Hanna M, Al-Khalidi HR, Ansell J, Atar D, Avezum A, Bahit MC, Diaz R, Easton JD, Ezekowitz JA, Flaker G, Garcia D, Geraldes M, Gersh BJ, Golitsyn S, Goto S, Hermosillo AG, Hohnloser SH, Horowitz J, Mohan P, Jansky P, Lewis BS, Lopez-Sendon JL, Pais P, Parkhomenko A, Verheugt FW, Zhu J,Wallentin L. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011;365: 981-992.
42. Kakkar AK, Mueller I, Bassand JP, Fitzmaurice DA, Goldhaber SZ, Goto S, Haas S, Hacke W, Lip GY, Mantovani LG, Turpie AG, van Eickels M, Misselwitz F, Rushton-Smith S, Kayani G, Wilkinson P, VerheugtFW. Risk profiles and antithrombotic treatment of patients newly diagnosed with atrial fibrillation at risk of stroke: perspectives from the international, observational, prospective GARFIELD registry. PLoS ONE 2013;8:e63479.