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dc.contributor.authorMehawej, Jordy
dc.contributor.authorSaczynski, Jane S.
dc.contributor.authorGurwitz, Jerry H.
dc.contributor.authorAbu, Hawa Ozien
dc.contributor.authorBamgbade, Benita A.
dc.contributor.authorWang, Weijia
dc.contributor.authorPaul, Tenes
dc.contributor.authorTrymbulak, Katherine
dc.contributor.authorSaleeba, Connor
dc.contributor.authorWang, Ziyue
dc.contributor.authorKiefe, Catarina I.
dc.contributor.authorGoldberg, Robert
dc.contributor.authorMcManus, David D.
dc.date2022-08-11T08:10:36.000
dc.date.accessioned2022-08-23T17:14:10Z
dc.date.available2022-08-23T17:14:10Z
dc.date.issued2020-08-28
dc.date.submitted2020-10-28
dc.identifier.citation<p>Mehawej J, Saczynski J, Gurwitz JH, Abu HO, Bamgbade BA, Wang WJ, Paul T, Trymbulak K, Saleeba C, Wang ZY, Kiefe CI, Goldberg RJ, McManus DD. Self-reported risk of stroke and factors associated with underestimation of stroke risk among older adults with atrial fibrillation: the SAGE-AF study. J Geriatr Cardiol. 2020 Aug;17(8):502-509. doi: 10.11909/j.issn.1671-5411.2020.08.004. PMID: 32952525; PMCID: PMC7475213. <a href="https://doi.org/10.11909/j.issn.1671-5411.2020.08.004">Link to article on publisher's site</a></p>
dc.identifier.issn1671-5411 (Linking)
dc.identifier.doi10.11909/j.issn.1671-5411.2020.08.004
dc.identifier.pmid32952525
dc.identifier.urihttp://hdl.handle.net/20.500.14038/46898
dc.description.abstractBackground: Though engaging patients with atrial fibrillation (AF) in understanding their stroke risk is encouraged by guidelines, little is known regarding AF patients' perceived stroke risk or its relationship with oral anticoagulation (OAC) use. We aim to identify factors associated with underestimation of stroke risk among older patients with AF and relate this to OAC use. Methods: Data are from the ongoing SAGE (Systematic Assessment of Geriatric Elements)-AF study, which included older patients ( > 65 years) with non-valvular AF and a CHA2DS2-VASc score of > /= 2. Participants reported their perceived risk of having a stroke without OAC. We compared the perceived risk to CHA2DS2-VASc predicted stroke risk and classified participants as "over" or "under" estimators, and identified factors associated with underestimation of risk using multiple logistic regression. Results: The average CHA2DS2-VASc score of 915 participants (average age: 75 years, 47% female, 86% white) was 4.3 +/- 1.6, 43% of participants had discordant predicted and self-reported stroke risks. Among the 376 participants at highest risk (CHA2DS2-VASc score > /= 5), 46% of participants underestimated their risk. Older participants ( > /= 85 years) were more likely and OAC treated patients less likely to underestimate their risk of developing a future stroke than respective comparison groups. Conclusions: A significant proportion of study participants misperceived their stroke risk, mostly by overestimating. Almost half of participants at high risk of stroke underestimated their risk, with older patients more likely to do so. Patients on OAC were less likely to underestimate their risk, suggesting that successful efforts to educate patients about their stroke risk may influence treatment choices.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=32952525&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7475213/
dc.subjectAnticoagulation
dc.subjectAtrial fibrillation
dc.subjectStroke
dc.subjectCardiology
dc.subjectCardiovascular Diseases
dc.subjectEpidemiology
dc.subjectHealth Communication
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.subjectNervous System Diseases
dc.titleSelf-reported risk of stroke and factors associated with underestimation of stroke risk among older adults with atrial fibrillation: the SAGE-AF study
dc.typeJournal Article
dc.source.journaltitleJournal of geriatric cardiology : JGC
dc.source.volume17
dc.source.issue8
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/1371
dc.identifier.contextkey20004612
html.description.abstract<p>Background: Though engaging patients with atrial fibrillation (AF) in understanding their stroke risk is encouraged by guidelines, little is known regarding AF patients' perceived stroke risk or its relationship with oral anticoagulation (OAC) use. We aim to identify factors associated with underestimation of stroke risk among older patients with AF and relate this to OAC use.</p> <p>Methods: Data are from the ongoing SAGE (Systematic Assessment of Geriatric Elements)-AF study, which included older patients ( > 65 years) with non-valvular AF and a CHA2DS2-VASc score of > /= 2. Participants reported their perceived risk of having a stroke without OAC. We compared the perceived risk to CHA2DS2-VASc predicted stroke risk and classified participants as "over" or "under" estimators, and identified factors associated with underestimation of risk using multiple logistic regression.</p> <p>Results: The average CHA2DS2-VASc score of 915 participants (average age: 75 years, 47% female, 86% white) was 4.3 +/- 1.6, 43% of participants had discordant predicted and self-reported stroke risks. Among the 376 participants at highest risk (CHA2DS2-VASc score > /= 5), 46% of participants underestimated their risk. Older participants ( > /= 85 years) were more likely and OAC treated patients less likely to underestimate their risk of developing a future stroke than respective comparison groups.</p> <p>Conclusions: A significant proportion of study participants misperceived their stroke risk, mostly by overestimating. Almost half of participants at high risk of stroke underestimated their risk, with older patients more likely to do so. Patients on OAC were less likely to underestimate their risk, suggesting that successful efforts to educate patients about their stroke risk may influence treatment choices.</p>
dc.identifier.submissionpathqhs_pp/1371
dc.contributor.departmentMeyers Primary Care Institute
dc.contributor.departmentDepartment of Medicine, Division of Geriatric Medicine
dc.contributor.departmentDepartment of Population and Quantitative Health Sciences
dc.contributor.departmentDivision of Cardiovascular Medicine, Department of Medicine
dc.source.pages502-509


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