Age Threshold for Ischemic Stroke Risk in Atrial Fibrillation.

Abstract:

:Background and Purpose- Although older age is one of the most important risk factor for stroke in atrial fibrillation (AF), the appropriate age threshold (eg, CHA2DS2-VASc score [congestive heart failure, hypertension, age ≥75 years (doubled), diabetes mellitus, prior stroke or transient ischemic attack (doubled), vascular disease, age 65-74 years, female], 1 point for age 65-74 years, 2 points for age ≥75 years) for increased risk is controversial because actual age thresholds may differ between countries and ethnic groups. We investigated the age threshold for ischemic stroke risk among Asian AF patients. Methods- Using National Health Insurance Service database, including 426 650 oral anticoagulant-naive nonvalvular AF patients from 2005 to 2015, with ≤2 nongender-related CHA2DS2-VASc risk scores (CHA2DS2-VASc score 0-2 in males, 1-3 in females), we assessed the risk of ischemic stroke in AF patients according to the age. Results- Patients who fulfill the age risk criterion (age, 65-74 years) without other risk factors showed a significantly higher risk of stroke (4.76 per 100 person-years [100PY]; adjusted hazard ratio, 2.25; 95% confidence interval [CI], 2.17-2.36) compared with patients with 1 risk score other than age (1.87/100PY). Patients aged 55 to 59 years with no risk factors showed similar risk of stroke (1.94/100PY; adjusted hazard ratio, 0.95; 95% confidence interval, 0.90-1.00) than patients with 1 risk score (2.06/100PY). Patients aged 65 to 69 years and no other risk factors had similar stroke risk (4.08/100PY; adjusted hazard ratio, 0.93; 95% confidence interval, 0.90-0.97) than patients with 2 nongender-related risk scores (4.42/100PY). Conclusions- Older age is the most important predictor of ischemic stroke in AF, particularly for patients with low to intermediate risk of stroke. These nationwide data suggest lowering the current age threshold (age, ≥65 years) in the CHA2DS2-VASc score to age ≥55 years might be appropriate among Asian patients with AF.

journal_name

Stroke

journal_title

Stroke

authors

Kim TH,Yang PS,Yu HT,Jang E,Uhm JS,Kim JY,Pak HN,Lee MH,Joung B,Lip GYH

doi

10.1161/STROKEAHA.118.021047

subject

Has Abstract

pub_date

2018-08-01 00:00:00

pages

1872-1879

issue

8

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.118.021047

journal_volume

49

pub_type

杂志文章

相关文献

STROKE文献大全
  • Characteristics of intracerebral hemorrhage during rivaroxaban treatment: comparison with those during warfarin.

    abstract:BACKGROUND AND PURPOSE:Neuroradiological characteristics and functional outcomes of patients with intracerebral hemorrhage (ICH) during novel oral anticoagulant treatment were not well defined. We examined these in comparison with those during warfarin treatment. METHODS:The consecutive 585 patients with ICH admitted ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.114.006661

    authors: Hagii J,Tomita H,Metoki N,Saito S,Shiroto H,Hitomi H,Kamada T,Seino S,Takahashi K,Baba Y,Sasaki S,Uchizawa T,Iwata M,Matsumoto S,Osanai T,Yasujima M,Okumura K

    更新日期:2014-09-01 00:00:00

  • Mevastatin, an HMG-CoA reductase inhibitor, reduces stroke damage and upregulates endothelial nitric oxide synthase in mice.

    abstract:BACKGROUND AND PURPOSE:The 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) lower serum cholesterol and decrease the incidence of stroke and cardiovascular disease. There is growing evidence that statins exert some of their beneficial effects independent of cholesterol lowering. Indeed, we...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.32.4.980

    authors: Amin-Hanjani S,Stagliano NE,Yamada M,Huang PL,Liao JK,Moskowitz MA

    更新日期:2001-04-01 00:00:00

  • Finding the most powerful measures of the effectiveness of tissue plasminogen activator in the NINDS tPA stroke trial.

    abstract:BACKGROUND AND PURPOSE:We sought to identify the most powerful binary measures of the treatment effect of tissue plasminogen activator (tPA) in the National Institute of Neurological Disorders and Stroke (NINDS) rTPA Stroke Trial. METHODS:Using the Classification and Regression Tree (CART) algorithm, we evaluated bina...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.31.10.2335

    authors: Broderick JP,Lu M,Kothari R,Levine SR,Lyden PD,Haley EC,Brott TG,Grotta J,Tilley BC,Marler JR,Frankel M

    更新日期:2000-10-01 00:00:00

  • Neonatal cerebral sinovenous thrombosis from symptom to outcome.

    abstract:BACKGROUND AND PURPOSE:Cerebral sinovenous thrombosis is a rare disease with severe neurological sequelae. The aim of this retrospective multicenter study was to investigate the clinical course, possible risk factors, and outcome of a cohort of neonatal patients with sinovenous thrombosis and, second, to estimate the i...

    journal_title:Stroke

    pub_type: 杂志文章,多中心研究

    doi:10.1161/STROKEAHA.110.583542

    authors: Berfelo FJ,Kersbergen KJ,van Ommen CH,Govaert P,van Straaten HL,Poll-The BT,van Wezel-Meijler G,Vermeulen RJ,Groenendaal F,de Vries LS,de Haan TR

    更新日期:2010-07-01 00:00:00

  • Treatment of hyperglycemia in ischemic stroke (THIS): a randomized pilot trial.

    abstract:BACKGROUND AND PURPOSE:Hyperglycemia may worsen brain injury during acute cerebral infarction. We tested the feasibility and tolerability of aggressive hyperglycemia correction with intravenous insulin compared with usual care during acute cerebral infarction. METHODS:We conducted a randomized, multicenter, blinded pi...

    journal_title:Stroke

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1161/STROKEAHA.107.493544

    authors: Bruno A,Kent TA,Coull BM,Shankar RR,Saha C,Becker KJ,Kissela BM,Williams LS

    更新日期:2008-02-01 00:00:00

  • Early recurrent embolism associated with nonvalvular atrial fibrillation: a retrospective study.

    abstract::Nonvalvular atrial fibrillation (NVAF) can be a source of cardiogenic brain embolism. We retrospectively reviewed the clinical features of 56 patients with acute brain infarction and NVAF. Based on clinical criteria, 35 infarcts (63%) were classified as probably embolic, 13 infarcts (23%) as probably nonembolic and 8 ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.14.5.688

    authors: Hart RG,Coull BM,Hart D

    更新日期:1983-09-01 00:00:00

  • Topography and temporal evolution of hypoxic viable tissue identified by 18F-fluoromisonidazole positron emission tomography in humans after ischemic stroke.

    abstract:BACKGROUND AND PURPOSE:We sought to characterize the spatial and temporal evolution of human cerebral infarction. Using a novel method of quantitatively mapping the distribution of hypoxic viable tissue identified by 18F-fluoromisonidazole (18F-FMISO) PET relative to the final infarct, we determined its evolution and s...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.STR.0000094422.74023.FF

    authors: Markus R,Reutens DC,Kazui S,Read S,Wright P,Chambers BR,Sachinidis JI,Tochon-Danguy HJ,Donnan GA

    更新日期:2003-11-01 00:00:00

  • South Asian patients with ischemic stroke: intracranial large arteries are the predominant site of disease.

    abstract:BACKGROUND AND PURPOSE:South Asians are the most prevalent ethnic group in the world. Intracranial disease is the most common vascular lesion worldwide. METHODS:We prospectively studied 200 consecutive ethnic South Asian patients with acute ischemic stroke in Singapore. RESULTS:Intracranial large-artery disease was p...

    journal_title:Stroke

    pub_type: 信件

    doi:10.1161/STROKEAHA.107.484584

    authors: De Silva DA,Woon FP,Lee MP,Chen CP,Chang HM,Wong MC

    更新日期:2007-09-01 00:00:00

  • Risk of thromboembolic events in controlled trials of rFVIIa in spontaneous intracerebral hemorrhage.

    abstract:BACKGROUND AND PURPOSE:Recombinant activated factor VII (rFVIIa) reduces hematoma expansion and improves outcome after intracerebral hemorrhage (ICH), with an apparent increase in nonfatal thromboembolic events (TEs) with higher doses. Despite low incidences of such events in rFVIIa-treated hemophiliacs, the frequency ...

    journal_title:Stroke

    pub_type: 杂志文章,meta分析

    doi:10.1161/STROKEAHA.107.493601

    authors: Diringer MN,Skolnick BE,Mayer SA,Steiner T,Davis SM,Brun NC,Broderick JP

    更新日期:2008-03-01 00:00:00

  • Incidence of aneurysmal subarachnoid hemorrhage in Shimokita, Japan, from 1989 to 1998.

    abstract:BACKGROUND AND PURPOSE:The incidence of subarachnoid hemorrhage (SAH) has been investigated in many studies. A recent study in Izumo, Japan, indicates that the incidence of SAH is as high as that in Finland. The purpose of this study was to confirm the high incidence of SAH in Japan. METHODS:The incidence rate of SAH ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/hs0102.101891

    authors: Ohkuma H,Fujita S,Suzuki S

    更新日期:2002-01-01 00:00:00

  • Asymptomatic embolization predicts stroke and TIA risk in patients with carotid artery stenosis.

    abstract:BACKGROUND AND PURPOSE:Improved methods of identifying patients at high risk of thromboembolism would allow improved targeting of therapy. One such situation is carotid artery stenosis. This is associated with an increased risk of stroke, which can be reduced by carotid endarterectomy. However, the risk-benefit ratio i...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.30.7.1440

    authors: Molloy J,Markus HS

    更新日期:1999-07-01 00:00:00

  • Mismatch Profile Influences Outcome After Mechanical Thrombectomy.

    abstract:BACKGROUND AND PURPOSE:Mechanical thrombectomy (MT) is the recommended treatment for acute ischemic stroke caused by anterior circulation large vessel occlusion. However, despite a high rate of reperfusion, the clinical response to successful MT remains highly variable in the early time window where optimal imaging sel...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.120.031929

    authors: Olivot JM,Albucher JF,Guenego A,Thalamas C,Mlynash M,Rousseau V,Drif A,Christensen S,Sommet A,Viguier A,Darcourt J,Calvière L,Menegon P,Raposo N,Januel AC,Bonneville F,Tourdias T,Mazighi M,Sibon I,Albers GW,Cognar

    更新日期:2021-01-01 00:00:00

  • Cerebrovascular ischemic events with high positive anticardiolipin antibodies.

    abstract:BACKGROUND AND PURPOSE:The aim of our study was to characterize the patient profile and prognostic value associated with high positive IgG (>100 GPL) anticardiolipin antibodies (aCL). METHODS:We studied the clinical, laboratory, radiological, and prospective historical features of ischemic cerebrovascular disease in p...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.29.11.2245

    authors: Verro P,Levine SR,Tietjen GE

    更新日期:1998-11-01 00:00:00

  • Left ventricular mass indexed to height and prevalent MRI cerebrovascular disease in an African American cohort: the Atherosclerotic Risk in Communities study.

    abstract:BACKGROUND AND PURPOSE:Previous studies have demonstrated that echocardiographic left ventricular mass (LVM) is an independent risk factor for stroke in whites. Despite the greater burden of stroke, the echocardiographic predictors of stroke in African Americans remain poorly understood. METHODS:This investigation is ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000154893.68957.55

    authors: Fox ER,Taylor HA Jr,Benjamin EJ,Ding J,Liebson PR,Arnett D,Quin EM,Skelton TN

    更新日期:2005-03-01 00:00:00

  • Low-grade carotid stenosis: looking beyond the lumen with MRI.

    abstract:BACKGROUND AND PURPOSE:The management of carotid atherosclerosis is well-established for symptomatic stenosis above 69%, but the optimal approach for managing lower degrees of narrowing remains uncertain. Because the risk of stroke increases with higher grades of stenosis, we are inclined to consider low-grade disease ...

    journal_title:Stroke

    pub_type: 杂志文章,评审

    doi:10.1161/01.STR.0000185726.83152.00

    authors: Wasserman BA,Wityk RJ,Trout HH 3rd,Virmani R

    更新日期:2005-11-01 00:00:00

  • Impact of chronic kidney disease on carotid atherosclerosis according to blood pressure category: the Suita study.

    abstract:BACKGROUND AND PURPOSE:We aimed to clarify the association of chronic kidney disease (CKD) with carotid atherosclerosis and the impact of CKD on carotid atherosclerosis according to blood pressure categories in an urban general population. METHODS:We studied 3466 Japanese individuals (35-93 years old) in the Suita Stu...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.113.002957

    authors: Ohara T,Kokubo Y,Toyoda K,Watanabe M,Koga M,Nakamura S,Nagatsuka K,Minematsu K,Nakagawa M,Miyamoto Y

    更新日期:2013-12-01 00:00:00

  • Coffee and tea consumption and risk of stroke subtypes in male smokers.

    abstract:BACKGROUND AND PURPOSE:Coffee and tea consumption could potentially reduce the risk of stroke because these beverages have antioxidant properties, and coffee may improve insulin sensitivity. We examined the associations of coffee and tea consumption with risk of stroke subtypes. METHODS:We used prospective data from t...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.107.504183

    authors: Larsson SC,Männistö S,Virtanen MJ,Kontto J,Albanes D,Virtamo J

    更新日期:2008-06-01 00:00:00

  • Prestroke Disability Predicts Adverse Poststroke Outcome: A Registry-Based Prospective Cohort Study of Acute Stroke.

    abstract::Background and Purpose- Information on what effect disability before stroke can have on stroke outcome is lacking. We assessed prestroke disability in relation to poststroke hospital outcome. Methods- Analysis of prospectively collected data from the Sentinel Stroke National Audit Programme. A total of 1656 men (mean ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.119.027740

    authors: Han TS,Fry CH,Gulli G,Affley B,Robin J,Irvin-Sellers M,Fluck D,Kakar P,Sharma S,Sharma P

    更新日期:2020-02-01 00:00:00

  • Concomitant headache influences long-term prognosis after acute cerebral ischemia of noncardioembolic origin.

    abstract:BACKGROUND AND PURPOSE:Acute cerebral ischemia is frequently associated with headache. It is unknown whether concomitant headache reflects a partly different pathogenesis, and thus, may influence long-term prognosis after stroke. Here, we compared the long-term risk of recurrent vascular events in patients in whom a tr...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.113.002217

    authors: Maino A,Algra A,Koudstaal PJ,van Zwet EW,Ferrari MD,Wermer MJ,LiLAC Study Group.

    更新日期:2013-09-01 00:00:00

  • Estimation of error limits for cerebral blood flow values obtained from xenon-133 clearance curves.

    abstract::I provide the theoretical basis for an error calculus for measurements of cerebral blood flow using a freely diffusible tracer substance such as xenon-133. The use of the error calculus is exemplified by a study of the effect on the error margins in measurements of gray matter blood flow from flow level, relative weig...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.20.2.205

    authors: Ryding E

    更新日期:1989-02-01 00:00:00

  • Systematic Review of Guidelines for the Management of Asymptomatic and Symptomatic Carotid Stenosis.

    abstract:BACKGROUND AND PURPOSE:We systematically compared and appraised contemporary guidelines on management of asymptomatic and symptomatic carotid artery stenosis. METHODS:We systematically searched for guideline recommendations on carotid endarterectomy (CEA) or carotid angioplasty/stenting (CAS) published in any language...

    journal_title:Stroke

    pub_type: 杂志文章,评审

    doi:10.1161/STROKEAHA.115.003390

    authors: Abbott AL,Paraskevas KI,Kakkos SK,Golledge J,Eckstein HH,Diaz-Sandoval LJ,Cao L,Fu Q,Wijeratne T,Leung TW,Montero-Baker M,Lee BC,Pircher S,Bosch M,Dennekamp M,Ringleb P

    更新日期:2015-11-01 00:00:00

  • Stroke in the People's Republic of China. I. Geographic variations in incidence and risk factors.

    abstract:BACKGROUND AND PURPOSE:Stroke is a major cause of death in the People's Republic of China (PRC), and the geographic distribution of stroke death varies substantially. We conducted an ecological analysis to investigate the relationship of prevalence of hypertension and other risk factors with stroke incidence and mortal...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:

    authors: He J,Klag MJ,Wu Z,Whelton PK

    更新日期:1995-12-01 00:00:00

  • PERK (Protein Kinase RNA-Like ER Kinase) Branch of the Unfolded Protein Response Confers Neuroprotection in Ischemic Stroke by Suppressing Protein Synthesis.

    abstract::Background and Purpose- Ischemic stroke impairs endoplasmic reticulum (ER) function, causes ER stress, and activates the unfolded protein response. The unfolded protein response consists of 3 branches controlled by ER stress sensor proteins, which include PERK (protein kinase RNA-like ER kinase). Activated PERK phosph...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.120.029071

    authors: Wang YC,Li X,Shen Y,Lyu J,Sheng H,Paschen W,Yang W

    更新日期:2020-05-01 00:00:00

  • Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease.

    abstract::In this retrospective analysis we report our treatment experience in 65 consecutive patients with clinical signs of severe brainstem ischemia with angiographically demonstrated thrombotic vertebrobasilar artery occlusions who received either local intra-arterial thrombolytic therapy (urokinase or streptokinase) (43 pa...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.19.10.1216

    authors: Hacke W,Zeumer H,Ferbert A,Brückmann H,del Zoppo GJ

    更新日期:1988-10-01 00:00:00

  • Relation of coronary atherosclerosis and apolipoprotein E genotypes in Alzheimer patients.

    abstract:BACKGROUND AND PURPOSE:Apolipoprotein E (apoE) epsilon 4 allele has been associated with a high risk for coronary heart disease. Increased frequency of the epsilon 4 allele has also been reported in patients with late-onset familial and sporadic Alzheimer's disease (AD). The aim of this study was to investigate the deg...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.26.5.743

    authors: Kosunen O,Talasniemi S,Lehtovirta M,Heinonen O,Helisalmi S,Mannermaa A,Paljärvi L,Ryynänen M,Riekkinen PJ Sr,Soininen H

    更新日期:1995-05-01 00:00:00

  • Declining Admission and Mortality Rates for Subarachnoid Hemorrhage in Canada Between 2004 and 2015.

    abstract::Background and Purpose- The purpose of this study was to assess recent trends in the admission and mortality rates for subarachnoid hemorrhage in Canada. Methods- This retrospective cross-sectional study was based on data retrieved from the Canadian Institute for Health Information for all patients diagnosed with suba...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.118.022332

    authors: Chan V,Lindsay P,McQuiggan J,Zagorski B,Hill MD,O'Kelly C

    更新日期:2018-11-21 00:00:00

  • Late measures of brain injury after neonatal hypoxia-ischemia in mice.

    abstract:BACKGROUND AND PURPOSE:This work was undertaken to determine to what degree long-term neurofunctional outcome of neonatal hypoxic-ischemic (HI) brain injury in mice correlates with anatomical extent of cerebral damage assessed by magnetic resonance imaging (MRI) and histopathology. METHODS:On postnatal day 7, mice wer...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000137768.25203.df

    authors: Ten VS,Wu EX,Tang H,Bradley-Moore M,Fedarau MV,Ratner VI,Stark RI,Gingrich JA,Pinsky DJ

    更新日期:2004-09-01 00:00:00

  • Endothelial progenitor cell research in stroke: a potential shift in pathophysiological and therapeutical concepts.

    abstract:BACKGROUND AND PURPOSE:Stroke is the leading cause of disability in the Western world; however, few therapies are at hand to decrease this burden. SUMMARY OF REVIEW:Endothelial progenitor cells (EPCs) have been introduced in cardiovascular medicine as factotums. EPCs can repair damaged endothelium and attenuate the de...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.107.507251

    authors: Rouhl RP,van Oostenbrugge RJ,Damoiseaux J,Tervaert JW,Lodder J

    更新日期:2008-07-01 00:00:00

  • Intra-arterial thrombolytic therapy for acute basilar occlusion: pro.

    abstract::Acute thromboembolic occlusion of the basilar artery accounts for 6% to 10% of large-vessel stroke in humans. Because of the brain region supplied by this artery, the case fatality rate is the highest for all ischemic stroke subtypes, ranging from 40% to 86%. Patients who undergo successful recanalization of the basil...

    journal_title:Stroke

    pub_type: 杂志文章,评审

    doi:10.1161/01.STR.0000247897.33267.42

    authors: Smith WS

    更新日期:2007-02-01 00:00:00

  • Value of the non-invasive cerebrovascular laboratory in diagnosis of extracranial carotid artery disease. An analysis of 159 studies in 157 patients.

    abstract::Non-invasive vascular testing has proven to be an effective means of identifying patients with significant extracranial carotid artery disease. Such tests can yield valuable physiologic data in patients with TIAs and can identify patients with soft signs who may have significant carotid artery disease and who may be c...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.11.4.325

    authors: Goran A,Moore G

    更新日期:1980-07-01 00:00:00