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Ischemic Stroke in Patients With Congenital Heart Disease and Atrial Fibrillation.
Holmgren, Arvid; Giang, Kok Wai; Fedchenko, Maria; Eriksson, Peter; Dellborg, Mikael; Mandalenakis, Zacharias.
Afiliación
  • Holmgren A; Department of Molecular and Clinical Medicine/Cardiology Institute of Medicine, Sahlgrenska Academy, University of Gothenburg Sweden.
  • Giang KW; Department of Molecular and Clinical Medicine/Cardiology Institute of Medicine, Sahlgrenska Academy, University of Gothenburg Sweden.
  • Fedchenko M; Department of Medicine Region Västra Götaland, Sahlgrenska University Hospital/Östra, Geriatrics and Emergency Medicine/Östra Gothenburg Sweden.
  • Eriksson P; Department of Molecular and Clinical Medicine/Cardiology Institute of Medicine, Sahlgrenska Academy, University of Gothenburg Sweden.
  • Dellborg M; Department of Medicine Region Västra Götaland, Sahlgrenska University Hospital/Östra, Geriatrics and Emergency Medicine/Östra Gothenburg Sweden.
  • Mandalenakis Z; Department of Molecular and Clinical Medicine/Cardiology Institute of Medicine, Sahlgrenska Academy, University of Gothenburg Sweden.
J Am Heart Assoc ; 13(17): e032813, 2024 Sep 03.
Article en En | MEDLINE | ID: mdl-39190565
ABSTRACT

BACKGROUND:

Atrial fibrillation (AF) is a common arrhythmia in patients with congenital heart disease (CHD), but little is known about the risk for ischemic stroke among younger patients with CHD (aged <65 years) with AF. METHODS AND

RESULTS:

Using data from the National Swedish Patient Register and Cause of Death Register, we identified all patients with both CHD and AF born in Sweden between 1970 and 2017. The Swedish total population register was used to identify age- and sex-matched patients without CHD; those with AF were used as controls. Bottos hierarchical classification was used to define CHD as either complex or noncomplex. Controls were followed from the onset of AF until the index ischemic stroke, death, or end of study (December 31, 2017). We identified 951 patients with CHD with AF and 606 controls with AF. Among patients with both CHD and AF, 2.9% of patients (n=28) developed ischemic stroke, compared with 0.5% (n=3) in controls. When adjusted for age, sex, hypertension, and heart failure, a hazard ratio (HR) of 5.16 (95% CI, 1.52-17.46) was acquired. The HR in noncomplex CHD was 3.84 (95% CI, 1.07-13.84), and the HR in complex CHD was 8.34 (95% CI, 2.27-30.57). For patients born in 1970 to 1989, the HR in ischemic stroke was 7.35 (95% CI, 1.70-31.75). No adjusted HR for patients with CHD born in 1990 to 2017 could be acquired due to few events.

CONCLUSIONS:

The risk for ischemic stroke may be 5 times higher in patients with both CHD and AF compared with patients without CHD with AF. However, larger studies may be needed to confirm/refute these results.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Sistema de Registros / Accidente Cerebrovascular Isquémico / Cardiopatías Congénitas Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Am Heart Assoc Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Sistema de Registros / Accidente Cerebrovascular Isquémico / Cardiopatías Congénitas Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Am Heart Assoc Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido