Vascular Disease May Increase Stroke or Death Risk in A-Fib

Vascular disease independently tied to stroke or death risk in patients with atrial fibrillation

TUESDAY, May 24 (HealthDay News) -- Vascular disease, such as peripheral artery disease (PAD) or prior myocardial infarction (MI), is an independent risk factor for stroke or death in patients with atrial fibrillation (AF), according to a study published online April 19 in the Journal of Thrombosis and Haemostasis.

Lars Hvilsted Rasmussen, M.D., Ph.D., from Aarhus University Hospital in Denmark, and colleagues analyzed 57,053 individuals, aged 50 to 64 years, to assess the impact of vascular diseases on the risk of stroke and death in patients with AF. After a median follow-up of 4.8 years, the risk of vascular disease was calculated among 3,315 patients with incident AF. The primary end point was stroke or death, and secondary end points were stroke and death separately.

The investigators identified 417 patients with PAD and/or previous MI. Of these patients, the risk of stroke or death was significantly higher at one-year follow-up (crude hazard ratio [HR], 2.51). Risk estimates were similar for the end points of death or stroke, individually (crude HR, 2.48 and 1.77, respectively). After adjustment for risk factors within the Cardiac Failure, Hypertension, Age, Diabetes, Stroke (Doubled) score, the adjusted HR for death or stroke was 1.91, and for death was 1.97, in patients with vascular disease.

"Patients with vascular disease represent a 'high risk' population, which necessitates proactive management of all cardiovascular risk factors and effective thromboprophylaxis (that is, oral anticoagulation), which has been shown to significantly reduce the risk of stroke and death in AF," the authors write.

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