Epidemiology of ischemic stroke from atrial fibrillation in Dijon, France, from 1985 to 2006

被引:58
作者
Bejot, Y. [1 ,2 ]
Salem, D. Ben [3 ]
Osseby, G. V. [1 ,2 ]
Couvreur, G. [1 ,2 ]
Durier, J. [1 ,2 ]
Marie, C. [4 ]
Cottin, Y. [5 ,6 ,7 ]
Moreau, T. [1 ,2 ]
Giroud, M. [1 ,2 ]
机构
[1] Univ Hosp, Dijon Stroke Registry, Dept Neurol, INSERM,EA4184, F-21000 Dijon, France
[2] Univ Hosp, EA4184, Stroke Registry Dijon, Inst Veille Sanit, F-21000 Dijon, France
[3] Univ Hosp, Dept Neuroimaging, F-21000 Dijon, France
[4] Univ Burgundy, INSERM, Lab Pharmacodynam, U887, Dijon, France
[5] Univ Burgundy, Univ Hosp, IFR Sante STIC, LPPCE,Dept Cardiol, Dijon, France
[6] Univ Burgundy, Univ Hosp, IFR Sante STIC, LPPCE,Observ Infarctus Cote Or RICO, Dijon, France
[7] Fac Med Dijon, Dijon, France
关键词
COMMUNITY STROKE; RISK-FACTORS; INCIDENCE RATES; WARFARIN USE; POPULATION; SUBTYPES; ANTICOAGULATION; PREVALENCE; MANAGEMENT; TRENDS;
D O I
10.1212/01.wnl.0000341280.31919.bd
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Atrial fibrillation (AF) is strongly associated with age, and epidemiologic studies are needed to evaluate the impact of both aging of the population and the use of anticoagulant therapy in patients with AF on the incidence of cardioembolic stroke with AF (CE/AF stroke). Methods: We evaluated trends in incidence rates, risk factors, prestroke therapy, and survival in CE/AF stroke from a prospective population-based registry, from 1985 to 2006. Results: A total of 3,064 ischemic strokes, including 572 (18.7%) CE/ AF strokes, were recorded. Over the 22 years, a decrease in the incidence of overall CE/ AF stroke was noted (incidence rate ratio 0.9858, 95% confidence interval [CI] 0.9731-0.9986; p = 0.03). We observed a higher prevalence of previous AF, previous myocardial infarction, and patients aged > 70 years in CE/ AF stroke (p < 0.0001) whereas hypercholesterolemia was more prevalent in other ischemic strokes (p = 0.003). A significant increase in the use of anticoagulants and antiplatelet agents was noted, and was particularly pronounced for CE/ AF stroke with previous AF. For CE/ AF stroke, survival rates were 72% at 1 month (95% CI 0.68-0.76), 52% at 1 year (95% CI 0.48-0.56), and 43% at 2 years (95% CI 0.39-0.48), and remained lower than those of other ischemic stroke. Conclusions: The decrease in the incidence of cardioembolic/atrial fibrillation stroke in our study was probably due to a slight increase in the utilization of antithrombotic therapy in patients with atrial fibrillation, but the use of such therapies will have to increase further because of the expected aging of the population in coming years. Neurology (R) 2009; 72: 346-353
引用
收藏
页码:346 / 353
页数:8
相关论文
共 33 条
  • [1] CLASSIFICATION OF SUBTYPE OF ACUTE ISCHEMIC STROKE - DEFINITIONS FOR USE IN A MULTICENTER CLINICAL-TRIAL
    ADAMS, HP
    BENDIXEN, BH
    KAPPELLE, LJ
    BILLER, J
    LOVE, BB
    GORDON, DL
    MARSH, EE
    KASE, CS
    WOLF, PA
    BABIKIAN, VL
    LICATAGEHR, EE
    ALLEN, N
    BRASS, LM
    FAYAD, PB
    PAVALKIS, FJ
    WEINBERGER, JM
    TUHRIM, S
    RUDOLPH, SH
    HOROWITZ, DR
    BITTON, A
    MOHR, JP
    SACCO, RL
    CLAVIJO, M
    ROSENBAUM, DM
    SPARR, SA
    KATZ, P
    KLONOWSKI, E
    CULEBRAS, A
    CAREY, G
    MARTIR, NI
    FICARRA, C
    HOGAN, EL
    CARTER, T
    GURECKI, P
    MUNTZ, BK
    RAMIREZLASSEPAS, M
    TULLOCH, JW
    QUINONES, MR
    MENDEZ, M
    ZHANG, SM
    ALA, T
    JOHNSTON, KC
    ANDERSON, DC
    TARREL, RM
    NANCE, MA
    BUDLIE, SR
    DIERICH, M
    HELGASON, CM
    HIER, DB
    SHAPIRO, RA
    [J]. STROKE, 1993, 24 (01) : 35 - 41
  • [2] Ahmad O.B., AGE STANDARDIZATION
  • [3] [Anonymous], 2000, World Health Report 2000: Health Systems: Improving Performance
  • [4] Decrease in the stroke case fatality rates in a french population-based twenty-year study
    Bejot, Yannick
    Rouaud, Olivier
    Durier, Jerome
    Caillier, Marie
    Marie, Christine
    Freysz, Marc
    Yeguiayan, Jean-Michel
    Chantegret, Alban
    Osseby, Guy
    Moreau, Thibault
    Giroud, Maurice
    [J]. CEREBROVASCULAR DISEASES, 2007, 24 (05) : 439 - 444
  • [5] Stable stroke incidence rates but improved case-fatality 06 in Dijon, France, from 1985 to 2004
    Benatru, Isabelle
    Rouaud, Olivier
    Durier, Jerome
    Contegal, Fabienne
    Couvreur, Gregory
    Bejot, Yannick
    Osseby, Guy Victor
    Ben Salem, Douraieb
    Ricolfi, Frederic
    Moreau, Thibault
    Giroud, Maurice
    [J]. STROKE, 2006, 37 (07) : 1674 - 1679
  • [6] Ethnic disparities in incidence of stroke subtypes: Auckland Regional Community Stroke Study, 2002-2003
    Feigin, V
    Carter, K
    Hackett, M
    Barber, PA
    McNaughton, H
    Dyall, L
    Chen, MH
    Anderson, C
    [J]. LANCET NEUROLOGY, 2006, 5 (02) : 130 - 139
  • [7] A hospital-based and a population-based stroke registry yield different results: The experience in Dijon, France
    Giroud, M
    Lemesle, M
    Quantin, C
    Vourch, M
    Becker, F
    Milan, C
    BrunetLecomte, P
    Dumas, R
    [J]. NEUROEPIDEMIOLOGY, 1997, 16 (01) : 15 - 21
  • [8] Prevalence of diagnosed atrial fibrillation in adults - National implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) study
    Go, AS
    Hylek, EM
    Phillips, KA
    Chang, YC
    Henault, LE
    Selby, JV
    Singer, DE
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 285 (18): : 2370 - 2375
  • [9] Warfarin use among ambulatory patients with nonvalvular atrial fibrillation: The AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) study
    Go, AS
    Hylek, EM
    Borowsky, LH
    Phillips, KA
    Selby, JV
    Singer, DE
    [J]. ANNALS OF INTERNAL MEDICINE, 1999, 131 (12) : 927 - +
  • [10] Risk factors, outcome, and treatment in subtypes of ischemic stroke - The German Stroke Data Bank
    Grau, AJ
    Weimar, C
    Buggle, F
    Heinrich, A
    Goertler, M
    Neumaier, S
    Glahn, J
    Brandt, T
    Hacke, W
    Diener, HC
    [J]. STROKE, 2001, 32 (11) : 2559 - 2566