Vascular disease and ischemic stroke in patients with atrial fibrillation: Temporal trends and age-related differences.

IF 4.9 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Konsta Teppo, Elin Karlsson, Tuomas Kiviniemi, Olli Halminen, Ossi Lehtonen, Elis Kouki, Jari Haukka, Pirjo Mustonen, Jukka Putaala, Miika Linna, Juha Hartikainen, K E Juhani Airaksinen, Mika Lehto
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Abstract

Background and aims: We examined temporal trends and age-related differences in the prevalence of vascular diseases and in their association with ischemic stroke (IS) risk in patients with atrial fibrillation (AF).

Methods: The registry-based FinACAF study covered all patients with AF in Finland during 2007-2018. Incidence rate ratios (IRRs) of IS were computed with Poisson regression, and the interaction of vascular diseases with age and calendar year period was assessed.

Results: We identified 229,565 patients (50.0 % female; mean age 72.7 years) with incident AF. The overall prevalence of any vascular disease was 28.6 %, and the prevalence increased from 2007 to 2018, primarily among patients over 75 years. Overall, 5909 (2.6 %) patients experienced IS within the first year after AF diagnosis. Crude IS rate decreased continuously during the study period in both patients with and without vascular diseases, with the rates remaining consistently higher in patients with vascular diseases. Vascular diseases were independently associated with higher IS incidence among patients under 65 years (adjusted IRR with 95 % confidence interval 1.35 (1.10-1.66)), while among older patients, only peripheral artery disease was associated with IS, and other vascular conditions had no association with IS. No interactions between the calendar year period and vascular diseases with IS rate were observed.

Conclusions: The association between vascular diseases and IS has remained stable over time and vascular diseases were independently associated with higher incidence of IS particularly in patients with AF under the age of 65.

心房颤动患者的血管疾病和缺血性中风:时间趋势和年龄差异。
背景与目的我们研究了心房颤动(房颤)患者血管疾病患病率及其与缺血性中风(IS)风险相关性的时间趋势和年龄差异:以登记为基础的 FinACAF 研究涵盖了 2007-2018 年间芬兰的所有房颤患者。采用泊松回归法计算了IS的发病率比(IRR),并评估了血管疾病与年龄和日历年期间的交互作用:我们发现了 229,565 名房颤患者(50.0% 为女性;平均年龄 72.7 岁)。任何血管疾病的总患病率为 28.6%,2007 年至 2018 年患病率有所上升,主要是 75 岁以上的患者。总体而言,5909 名患者(2.6%)在确诊房颤后的第一年内经历了 IS。在研究期间,有血管疾病和无血管疾病患者的粗IS率均持续下降,有血管疾病患者的IS率始终较高。在 65 岁以下的患者中,血管疾病与较高的 IS 发生率独立相关(调整后 IRR,95% 置信区间为 1.35 (1.10-1.66)),而在老年患者中,只有外周动脉疾病与 IS 相关,其他血管疾病与 IS 无关。在日历年期间和血管疾病与IS率之间没有观察到相互作用:随着时间的推移,血管疾病与IS之间的关系保持稳定,血管疾病与较高的IS发病率独立相关,尤其是在65岁以下的房颤患者中。
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来源期刊
Atherosclerosis
Atherosclerosis 医学-外周血管病
CiteScore
9.80
自引率
3.80%
发文量
1269
审稿时长
36 days
期刊介绍: Atherosclerosis has an open access mirror journal Atherosclerosis: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atherosclerosis brings together, from all sources, papers concerned with investigation on atherosclerosis, its risk factors and clinical manifestations. Atherosclerosis covers basic and translational, clinical and population research approaches to arterial and vascular biology and disease, as well as their risk factors including: disturbances of lipid and lipoprotein metabolism, diabetes and hypertension, thrombosis, and inflammation. The Editors are interested in original or review papers dealing with the pathogenesis, environmental, genetic and epigenetic basis, diagnosis or treatment of atherosclerosis and related diseases as well as their risk factors.
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