Triphasic Changes in Ischemic Stroke Incidence With Age in Non-Valvular Atrial Fibrillation Patients - Pooled Analysis of the Shinken Database, J-RHYTHM Registry, and Fushimi AF Registry.

Circulation reports Pub Date : 2025-03-11 eCollection Date: 2025-04-10 DOI:10.1253/circrep.CR-25-0009
Shinya Suzuki, Takeshi Yamashita, Ken Okumura, Hirotsugu Atarashi, Masaharu Akao, Hiroshi Inoue
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Abstract

Background: The basis for the specific age threshold for increasing of ischemic stroke in non-valvular atrial fibrillation (NVAF) patients has not been fully evaluated.

Methods and results: We conducted a pooled analysis of 3,588 Japanese NVAF patients without anticoagulation therapy from the Shinken Database (n=1,099), the J-RHYTHM Registry (n=1,002), and the Fushimi AF Registry (n=1,487) to determine the incidence of ischemic stroke by age group; patients aged between 31 and 90 years (n=3,455) were analyzed. During a follow-up period of 1.47 years, 69 ischemic strokes occurred (1.33% per year). The incidence of ischemic stroke exhibited triphasic changes as follows: first, it ranged from 0.00% per year to 0.41% per year across the age groups between 31-35 and 46-50 years. Second, it then rose to 1.58% per year in the 56-60-years age group, remaining around 1% per year across the age groups between 56-60 and 71-75 years, with rates ranging from 0.83% to 1.58% per year. Last, it further increased to 2.35% per year in the 76-80-year age group, remaining around 2.5% per year across the age groups between 76-80 and 86-90 years.

Conclusions: The incidence of ischemic stroke in NVAF patients exhibits triphasic changes with age, with notable increases observed in patients aged in their late 50s and late 70s.

非瓣膜性房颤患者缺血性卒中发病率随年龄的三相变化——Shinken数据库、J-RHYTHM登记处和Fushimi房颤登记处的汇总分析
背景:非瓣膜性房颤(NVAF)患者缺血性卒中增加的特定年龄阈值的依据尚未得到充分评估。方法和结果:我们对来自Shinken数据库(n=1,099)、J-RHYTHM Registry (n=1,002)和Fushimi AF Registry (n=1,487)的3,588名未接受抗凝治疗的日本非瓣膜性房颤患者进行了汇总分析,以确定各年龄组缺血性卒中的发生率;年龄在31 - 90岁之间的患者(n=3,455)进行了分析。在1.47年的随访期间,发生了69例缺血性中风(每年1.33%)。缺血性脑卒中的发病率表现为三个阶段的变化:第一,在31-35岁和46-50岁年龄组中,发病率从每年0.00%到每年0.41%不等。其次,在56-60岁年龄组中上升到每年1.58%,在56-60岁和71-75岁年龄组中保持在每年1%左右,每年的比率从0.83%到1.58%不等。最后,76-80岁年龄组的死亡率进一步上升至每年2.35%,76-80岁和86-90岁年龄组的死亡率保持在每年2.5%左右。结论:非瓣瓣性房颤患者缺血性脑卒中的发生率随年龄呈三期变化,在50岁晚期和70岁晚期患者发生率明显增高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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