Delayed diagnosis of atrial fibrillation after first-ever stroke increases recurrent stroke risk

a 5-year nationwide follow-up study

Ping Song Chou, Bo Lin Ho, Yi Hsin Chan, Min Hsien Wu, Han Hwa Hu, A. Ching Chao

研究成果: 雜誌貢獻文章

2 引文 (Scopus)

摘要

Background: Delayed detection of atrial fibrillation (AF) is common in patients with stroke. However, it is not well known whether delayed identification of AF in patients with stroke affects the prognosis of patients. Aims: To evaluate the association between the timing of AF diagnosis after stroke and clinical outcomes. Methods: We identified a cohort of all patients admitted with a primary diagnosis of first-ever ischaemic stroke, which was categorised into three groups, namely, non-AF, AF presenting with stroke and delayed AF diagnosis groups. The study patients were individually followed for 5 years to evaluate the occurrence of recurrent stroke and death. Results: In total, 17 399 patients were hospitalised with first-ever ischemic stroke, of whom 16 261 constituted the non-AF group, 907 the AF presenting with stroke group and 231 the delayed AF diagnosis group. During the 5-year follow up, 2773 (17.1%), 175 (19.3%) and 68 (29.4%) patients in the non-AF, AF presenting with stroke and delayed AF diagnosis groups, respectively, were hospitalised for recurrent stroke. The delayed AF diagnosis group exhibited a 1.57-times higher risk of recurrent stroke than the AF presenting with stroke group, after adjustment for the CHA2DS2-VASc scores (adjusted hazard ratio (HR): 1.57; 95% confidence interval (CI) = 1.19–2.08; P = 0.002). In addition, delayed diagnosis of AF significantly increased the risk of recurrent stroke in men, but not in women, after adjustment for the CHA2DS2-VASc scores. Conclusion: Delayed diagnosis of AF after stroke increased the risk of recurrent stroke, particularly in men.
原文英語
頁(從 - 到)661-667
頁數7
期刊Internal Medicine Journal
48
發行號6
DOIs
出版狀態已發佈 - 六月 1 2018

指紋

Delayed Diagnosis
Atrial Fibrillation
Stroke

ASJC Scopus subject areas

  • Internal Medicine

引用此文

Delayed diagnosis of atrial fibrillation after first-ever stroke increases recurrent stroke risk : a 5-year nationwide follow-up study. / Chou, Ping Song; Ho, Bo Lin; Chan, Yi Hsin; Wu, Min Hsien; Hu, Han Hwa; Chao, A. Ching.

於: Internal Medicine Journal, 卷 48, 編號 6, 01.06.2018, p. 661-667.

研究成果: 雜誌貢獻文章

Chou, Ping Song ; Ho, Bo Lin ; Chan, Yi Hsin ; Wu, Min Hsien ; Hu, Han Hwa ; Chao, A. Ching. / Delayed diagnosis of atrial fibrillation after first-ever stroke increases recurrent stroke risk : a 5-year nationwide follow-up study. 於: Internal Medicine Journal. 2018 ; 卷 48, 編號 6. 頁 661-667.
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title = "Delayed diagnosis of atrial fibrillation after first-ever stroke increases recurrent stroke risk: a 5-year nationwide follow-up study",
abstract = "Background: Delayed detection of atrial fibrillation (AF) is common in patients with stroke. However, it is not well known whether delayed identification of AF in patients with stroke affects the prognosis of patients. Aims: To evaluate the association between the timing of AF diagnosis after stroke and clinical outcomes. Methods: We identified a cohort of all patients admitted with a primary diagnosis of first-ever ischaemic stroke, which was categorised into three groups, namely, non-AF, AF presenting with stroke and delayed AF diagnosis groups. The study patients were individually followed for 5 years to evaluate the occurrence of recurrent stroke and death. Results: In total, 17 399 patients were hospitalised with first-ever ischemic stroke, of whom 16 261 constituted the non-AF group, 907 the AF presenting with stroke group and 231 the delayed AF diagnosis group. During the 5-year follow up, 2773 (17.1{\%}), 175 (19.3{\%}) and 68 (29.4{\%}) patients in the non-AF, AF presenting with stroke and delayed AF diagnosis groups, respectively, were hospitalised for recurrent stroke. The delayed AF diagnosis group exhibited a 1.57-times higher risk of recurrent stroke than the AF presenting with stroke group, after adjustment for the CHA2DS2-VASc scores (adjusted hazard ratio (HR): 1.57; 95{\%} confidence interval (CI) = 1.19–2.08; P = 0.002). In addition, delayed diagnosis of AF significantly increased the risk of recurrent stroke in men, but not in women, after adjustment for the CHA2DS2-VASc scores. Conclusion: Delayed diagnosis of AF after stroke increased the risk of recurrent stroke, particularly in men.",
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T2 - a 5-year nationwide follow-up study

AU - Chou, Ping Song

AU - Ho, Bo Lin

AU - Chan, Yi Hsin

AU - Wu, Min Hsien

AU - Hu, Han Hwa

AU - Chao, A. Ching

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N2 - Background: Delayed detection of atrial fibrillation (AF) is common in patients with stroke. However, it is not well known whether delayed identification of AF in patients with stroke affects the prognosis of patients. Aims: To evaluate the association between the timing of AF diagnosis after stroke and clinical outcomes. Methods: We identified a cohort of all patients admitted with a primary diagnosis of first-ever ischaemic stroke, which was categorised into three groups, namely, non-AF, AF presenting with stroke and delayed AF diagnosis groups. The study patients were individually followed for 5 years to evaluate the occurrence of recurrent stroke and death. Results: In total, 17 399 patients were hospitalised with first-ever ischemic stroke, of whom 16 261 constituted the non-AF group, 907 the AF presenting with stroke group and 231 the delayed AF diagnosis group. During the 5-year follow up, 2773 (17.1%), 175 (19.3%) and 68 (29.4%) patients in the non-AF, AF presenting with stroke and delayed AF diagnosis groups, respectively, were hospitalised for recurrent stroke. The delayed AF diagnosis group exhibited a 1.57-times higher risk of recurrent stroke than the AF presenting with stroke group, after adjustment for the CHA2DS2-VASc scores (adjusted hazard ratio (HR): 1.57; 95% confidence interval (CI) = 1.19–2.08; P = 0.002). In addition, delayed diagnosis of AF significantly increased the risk of recurrent stroke in men, but not in women, after adjustment for the CHA2DS2-VASc scores. Conclusion: Delayed diagnosis of AF after stroke increased the risk of recurrent stroke, particularly in men.

AB - Background: Delayed detection of atrial fibrillation (AF) is common in patients with stroke. However, it is not well known whether delayed identification of AF in patients with stroke affects the prognosis of patients. Aims: To evaluate the association between the timing of AF diagnosis after stroke and clinical outcomes. Methods: We identified a cohort of all patients admitted with a primary diagnosis of first-ever ischaemic stroke, which was categorised into three groups, namely, non-AF, AF presenting with stroke and delayed AF diagnosis groups. The study patients were individually followed for 5 years to evaluate the occurrence of recurrent stroke and death. Results: In total, 17 399 patients were hospitalised with first-ever ischemic stroke, of whom 16 261 constituted the non-AF group, 907 the AF presenting with stroke group and 231 the delayed AF diagnosis group. During the 5-year follow up, 2773 (17.1%), 175 (19.3%) and 68 (29.4%) patients in the non-AF, AF presenting with stroke and delayed AF diagnosis groups, respectively, were hospitalised for recurrent stroke. The delayed AF diagnosis group exhibited a 1.57-times higher risk of recurrent stroke than the AF presenting with stroke group, after adjustment for the CHA2DS2-VASc scores (adjusted hazard ratio (HR): 1.57; 95% confidence interval (CI) = 1.19–2.08; P = 0.002). In addition, delayed diagnosis of AF significantly increased the risk of recurrent stroke in men, but not in women, after adjustment for the CHA2DS2-VASc scores. Conclusion: Delayed diagnosis of AF after stroke increased the risk of recurrent stroke, particularly in men.

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KW - CHA2DS2-VASc score

KW - continuous cardiac monitoring

KW - National Health Insurance Research Database

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