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Titolo:
Factors associated with ischemic stroke during aspirin therapy in atrial fibrillation - Analysis of 2012 participants in the SPAF I-III clinical trials
Autore:
Hart, RG; Pearce, LA; McBride, R; Rothbart, RM; Asinger, RW;
Indirizzi:
Univ Texas, Hlth Sci Ctr, Dept Med Neurol, San Antonio, TX 78284 USA Univ Texas San Antonio TX USA 78284 Med Neurol, San Antonio, TX 78284 USA Stat & Epidemiol Res Corp, Seattle, WA USA Stat & Epidemiol Res Corp Seattle WA USA emiol Res Corp, Seattle, WA USA LeBauer Cardiol Associates, Greensboro, NC USA LeBauer Cardiol AssociatesGreensboro NC USA ociates, Greensboro, NC USA Hennepin Cty Med Ctr, Minneapolis, MN 55415 USA Hennepin Cty Med Ctr Minneapolis MN USA 55415 , Minneapolis, MN 55415 USA
Titolo Testata:
STROKE
fascicolo: 6, volume: 30, anno: 1999,
pagine: 1223 - 1229
SICI:
0039-2499(199906)30:6<1223:FAWISD>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
HORMONE REPLACEMENT THERAPY; VENOUS THROMBOEMBOLISM; CARDIOVASCULAR-DISEASE; POSTMENOPAUSAL WOMEN; PULMONARY-EMBOLISM; RISK-FACTORS; FOLLOW-UP; ESTROGEN; ANTICOAGULATION; PREVENTION;
Keywords:
atrial fibrillation; cerebral embolism; estrogens; risk factors; stroke prevention;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
44
Recensione:
Indirizzi per estratti:
Indirizzo: Hart, RG Univ Texas, Hlth Sci Ctr, Dept Med Neurol, 7703 Floyd Curl Dr, San Antonio, Univ Texas 7703 Floyd Curl Dr San Antonio TX USA 78284 n Antonio,
Citazione:
R.G. Hart et al., "Factors associated with ischemic stroke during aspirin therapy in atrial fibrillation - Analysis of 2012 participants in the SPAF I-III clinical trials", STROKE, 30(6), 1999, pp. 1223-1229

Abstract

Background and Purpose-Nonvalvular atrial fibrillation (AF) is a strong, independent risk factor for stroke, but the absolute rate of stroke varies widely among AF patients, importantly influencing the potential benefit of antithrombotic prophylaxis. We explore factors associated with ischemic stroke in AF patients taking aspirin. Methods-We performed multivariate logistic regression analysis of 2012 participants given aspirin alone or in combination with low, inefficacious doses of warfarin in the Stroke Prevention in Atrial Fibrillation I-III trialsfollowed for a mean of 2.0 years, during which 130 ischemic strokes were observed. Results-Age (relative risk [RR]=1.8 per decade, P<0.001), female sex (RR=1.6, P=0.01), history of hypertension (RR=2.0, P<0.001), systolic blood pressure >160 mm Hg (RR=2.3, P<0.001), and prior stroke or transient ischemic attack (RR=2.9, P<0.001) were independently associated with increased strokerisk. Regular consumption of greater than or equal to 14 alcohol-containing drinks per week was associated with reduced stroke risk (adjusted RR=0.4,P=0.04). Among SPAF III participants, estrogen hormone replacement therapywas associated with a higher risk of ischemic stroke (adjusted RR=3.2, P=0.007). With the use of these variables, a risk stratification scheme for primary prevention separated participants into those with high (7.1%/y, 22% of the cohort), moderate (2.6%/y, 37% of the cohort), and low (0.9%/y, 41% of the cohort) rates of stroke. Ischemic strokes in low-risk participants were less often disabling (P<0.001). Conclusions-Patients with AF who have high and low rates of stroke during treatment with aspirin can be identified. However, validation of our risk stratification scheme is necessary before it can be applied with confidence to clinical management. Postmenopausal. estrogen replacement therapy and moderate alcohol consumption may additionally modify the risk of stroke in AF, but these findings require confirmation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 19:40:48