Time-varying differences in stroke recurrence risk between types of atrial fibrillation based on screening methods and timing of detection
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Le résumé fourni par la source
INTRODUCTION: Atrial fibrillation (AF) burden progresses with time. Among ischemic stroke (IS) patients, AF can be detected at different burden progression stages based on the timing and screening method. We hypothesized that AF detected after IS on 12-lead ECGs (ECG-AF) and via 14-day-Holter prolonged cardiac monitoring (AFDAS) are linked to lower IS recurrence risk than AF known before stroke occurrence (KAF) because of being at an earlier progression stage than KAF. Additionally, we posited that IS recurrence risk differences between AF types vary over time due to their differential progression stages. PATIENTS AND METHODS: Retrospective observational cohort study including IS/TIA patients with KAF, ECG-AF, and AFDAS [2018-2021]. Adjusted hazard ratios (aHR) were estimated using multivariable cause-specific Cox proportional-hazard models to compare IS recurrence between ECG-AF versus KAF and AFDAS versus KAF. Proportional hazards assumptions were tested to assess whether IS recurrence risk differences were time-varying. RESULTS: Of 758 AF patients (385 KAF, 236 ECG-AF, 137 AFDAS), 603 received anticoagulation and 59 experienced a recurrent IS after 1441 patient-years of follow-up. No IS recurrence risk differences were observed at the end of follow-up between ECG-AF and KAF (aHR 0.67, 95% CI 0.36-1.26), although ECG-AF showed lower risk only within the first year (aHR 0.15; 95% CI 0.04-0.56). AFDAS exhibited a lower IS recurrence risk than KAF (aHR 0.22, 95% CI 0.08-0.63), without time-varying differences. DISCUSSION: Differences in IS recurrence risk between ECG-AF and KAF varied over time. However, AFDAS showed a consistently lower IS risk than KAF throughout the entire study period.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Time-varying differences in stroke recurrence risk between types of atrial fibrillation based on screening methods and timing of detection
- Date Crossref
- 01/06/2025
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Western University Heart & Brain Laboratory pays non établi dans la noticeUniversité ou école supérieure
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Lawson Health Research Institute pays non établi dans la noticeÉtablissement de santé
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Lawson Research Institute pays non établi dans la noticeÉtablissement de santé
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Windsor Regional Hospital pays non établi dans la noticeÉtablissement de santé
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Robarts Clinical Trials pays non établi dans la noticeStructure de recherche
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Robarts Research Institute pays non établi dans la noticeStructure de recherche
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Schulich School of Medicine and Dentistry Department of Clinical Neurological Sciences pays non établi dans la noticeUniversité ou école supérieure
Heart & Brain Laboratory — Western University, Lawson Health Research Institute et Lawson Research Institute, avec 4 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.