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    Stroke as the Initial Manifestation of Atrial Fibrillation: The Framingham Heart Study

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    Authors
    Lubitz, Steven A.
    Yin, Xiaoyan
    McManus, David D.
    Weng, Lu-Chen
    Aparicio, Hugo J.
    Walkey, Allan J.
    Rafael Romero, Jose
    Kase, Carlos S.
    Ellinor, Patrick T.
    Wolf, Philip A.
    Seshadri, Sudha
    Benjamin, Emelia J.
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    UMass Chan Affiliations
    Department of Medicine, Division of Cardiovascular Medicine
    Document Type
    Journal Article
    Publication Date
    2017-02-01
    Keywords
    Cardiology
    Cardiovascular Diseases
    Nervous System Diseases
    
    Metadata
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    Link to Full Text
    https://doi.org/10.1161/STROKEAHA.116.015071
    Abstract
    BACKGROUND AND PURPOSE: To prevent strokes that may occur as the first manifestation of atrial fibrillation (AF), screening programs have been proposed to identify patients with undiagnosed AF who may be eligible for treatment with anticoagulation. However, the frequency with which patients with AF present with stroke as the initial manifestation of the arrhythmia is unknown. METHODS: We estimated the frequency with which AF may present as a stroke in 1809 community-based Framingham Heart Study participants with first-detected AF and without previous strokes, by tabulating the frequencies of strokes occurring on the same day, within 30 days before, 90 days before, and 365 days before first-detected AF. Using previously reported AF incidence rates, we estimated the incidence of strokes that may represent the initial manifestation of AF. RESULTS: We observed 87 strokes that occurred < /=1 year before AF detection, corresponding to 1.7% on the same day, 3.4% within 30 days before, 3.7% within 90 days before, and 4.8% < /=1 year before AF detection. We estimated that strokes may present as the initial manifestation of AF at a rate of 2 to 5 per 10 000 person-years, in both men and women. CONCLUSIONS: We observed that stroke is an uncommon but measureable presenting feature of AF. Our data imply that emphasizing cost-effectiveness of population-wide AF-screening efforts will be important given the relative infrequency with which stroke represents the initial manifestation of AF.
    Source
    Stroke. 2017 Feb;48(2):490-492. doi: 10.1161/STROKEAHA.116.015071. Epub 2017 Jan 12. Link to article on publisher's site
    DOI
    10.1161/STROKEAHA.116.015071
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/29147
    PubMed ID
    28082669
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1161/STROKEAHA.116.015071
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