Afib-Associated Strokes Rising
Nearly a quarter due to atrial fibrillation.
As the population ages, the number of afib and strokes associated with arrhythmia keep on growing, despite progress in direction of such patients, scientists found.
In 2003 - 2010, there have been about 3.2M hospitalizations coming from acute cerebrovascular accident, and 22% have been related to afib.
Increases over time have been found in the complete amount of afib-associated strokes -- starting with 70,953 (2003) up to 100,276 (2010) -- and the percent of strokes that have been associated to the arrhythmia -- from 23% up to 25% in females and from 18% up to 19% in males.
Patients need to understand the value of always taking the oral anticoagulants since the discontinuation rate with warfarin is nearly 45-50% and with newer oral anticoagulants it is 20-30%. So that is likely where the clinicians must step up and get our patients realize that they want to keep taking such drugs for the rest of life.
There were developments over last decade in prevention of strokes -- with the introduction of new oral anticoagulants -- and rhythm management programs for patients with afib, but the effect they have had on ischemic strokes incidence associated with the state remains uncertain.
New Research Results
To investigate the problem, scientists analyzed data in the NIS, identifying all hospitalizations 2003 - 2010 with a diagnosis both those who are and are not correlated with afib.
The absolute amount of strokes increased with time during the study interval -- from 334,897 (2003) up to 448,245 (2010) to, as did the amount of strokes associated with the arrhythmia. That reflected a rise in the quantity of afib-related hospitalizations from nearly 3M to nearly 3.4M, a tendency that had been noticed previously.
Going in the opposite way was mortality rate following the strokes, which fell to 9% for those related to afib and to 4.1% for other ones. Considering the study interval in general, the mortality rate has been more than double strokes associated with afib.
What Does It Mean
Because more people are living these strokes and survivors have a bigger risk of having one more, that's likely leading to the greater amounts of afib and strokes -related occasions.
Additionally, the prevalence of various CHADS2 risk factors congestive heart failure, stroke, diabetes, and hypertension -- increased over time. But the increase in the prevalence of those comorbidities and atrial fibrillation cannot completely account for the afib-related strokes rise.
Additional years of data would be needed to evaluate whether introduction of the innovative oral anticoagulants -- which started with the acceptance (Pradaxa) has changed the tendencies that were observed.
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