Atrial Fibrillation in Spontaneous Intracerebral Hemorrhage, Dijon Stroke Registry (2006–2017)
Background Atrial fibrillation (AF) represents a major indication for oral anticoagulants (OAC) that contribute to spontaneous intracerebral hemorrhage (ICH). This study evaluated AF prevalence among patients with ICH, temporal trends, and early functional outcomes and death of patients. Methods and...
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| Language: | English |
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Wiley
2021-09-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.020040 |
| _version_ | 1818590469675810816 |
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| author | Amélie Gabet Valérie Olié Yannick Béjot |
| author_facet | Amélie Gabet Valérie Olié Yannick Béjot |
| author_sort | Amélie Gabet |
| collection | DOAJ |
| description | Background Atrial fibrillation (AF) represents a major indication for oral anticoagulants (OAC) that contribute to spontaneous intracerebral hemorrhage (ICH). This study evaluated AF prevalence among patients with ICH, temporal trends, and early functional outcomes and death of patients. Methods and Results Patients with first‐ever ICH were prospectively recorded in the population‐based stroke registry of Dijon, France, (2006–2017). Association between AF and early outcome of patients with ICH (ordinal modified Rankin Scale score and death at discharge) were analyzed using ordinal and logistic regressions. Among 444 patients with ICH, 97 (21.9%) had AF, including 65 (14.6%) with previously known AF treated with OAC, and 13 (2.9%) with newly diagnosed AF. AF prevalence rose from 17.2% (2006–2011) to 25.8% (2012–2017) (P‐trend=0.05). An increase in the proportion of AF treated with OAC (11.3% to 17.5%, P‐trend=0.09) and newly diagnosed AF (1.5% to 4.2%, P‐trend=0.11) was observed. In multivariable analyses, after adjustment for premorbid OAC, AF was not significantly associated with ordinal modified Rankin Scale score (odds ratio [OR], 1.29; 95% CI, 0.69–2.42) or death (OR, 0.89; 95% CI, 0.40–1.96) in patients with ICH. Nevertheless, adjusted premorbid OAC use remained highly associated with a higher probability of death (OR, 2.53; 95% CI, 1.11–5.78). Conclusions AF prevalence and use of OAC among patients with ICH increased over time. Premorbid use of OAC was associated with poor outcome after ICH, thus suggesting a need to better identify ICH risk before initiating or pursuing OAC therapy in patients with AF, and to develop acute treatment and secondary prevention strategies after ICH in patients with AF. |
| first_indexed | 2024-12-16T09:57:02Z |
| format | Article |
| id | doaj.art-4d04be7efb4a490e9445fbfb1c8afc7a |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-16T09:57:02Z |
| publishDate | 2021-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-4d04be7efb4a490e9445fbfb1c8afc7a2022-12-21T22:35:53ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-09-01101710.1161/JAHA.120.020040Atrial Fibrillation in Spontaneous Intracerebral Hemorrhage, Dijon Stroke Registry (2006–2017)Amélie Gabet0Valérie Olié1Yannick Béjot2Santé Publique France Saint‐Maurice FranceSanté Publique France Saint‐Maurice FranceDijon Stroke Registry EA7460, Pathophysiology and Epidemiology of Cerebro‐Cardiovascular diseases University Hospital of DijonUniversity of BurgundyUniversité Bourgogne‐Franche‐Comté (UBFC) Dijon FranceBackground Atrial fibrillation (AF) represents a major indication for oral anticoagulants (OAC) that contribute to spontaneous intracerebral hemorrhage (ICH). This study evaluated AF prevalence among patients with ICH, temporal trends, and early functional outcomes and death of patients. Methods and Results Patients with first‐ever ICH were prospectively recorded in the population‐based stroke registry of Dijon, France, (2006–2017). Association between AF and early outcome of patients with ICH (ordinal modified Rankin Scale score and death at discharge) were analyzed using ordinal and logistic regressions. Among 444 patients with ICH, 97 (21.9%) had AF, including 65 (14.6%) with previously known AF treated with OAC, and 13 (2.9%) with newly diagnosed AF. AF prevalence rose from 17.2% (2006–2011) to 25.8% (2012–2017) (P‐trend=0.05). An increase in the proportion of AF treated with OAC (11.3% to 17.5%, P‐trend=0.09) and newly diagnosed AF (1.5% to 4.2%, P‐trend=0.11) was observed. In multivariable analyses, after adjustment for premorbid OAC, AF was not significantly associated with ordinal modified Rankin Scale score (odds ratio [OR], 1.29; 95% CI, 0.69–2.42) or death (OR, 0.89; 95% CI, 0.40–1.96) in patients with ICH. Nevertheless, adjusted premorbid OAC use remained highly associated with a higher probability of death (OR, 2.53; 95% CI, 1.11–5.78). Conclusions AF prevalence and use of OAC among patients with ICH increased over time. Premorbid use of OAC was associated with poor outcome after ICH, thus suggesting a need to better identify ICH risk before initiating or pursuing OAC therapy in patients with AF, and to develop acute treatment and secondary prevention strategies after ICH in patients with AF.https://www.ahajournals.org/doi/10.1161/JAHA.120.020040anticoagulantsatrial fibrillationepidemiologyintracerebral hemorrhageoutcomes |
| spellingShingle | Amélie Gabet Valérie Olié Yannick Béjot Atrial Fibrillation in Spontaneous Intracerebral Hemorrhage, Dijon Stroke Registry (2006–2017) Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease anticoagulants atrial fibrillation epidemiology intracerebral hemorrhage outcomes |
| title | Atrial Fibrillation in Spontaneous Intracerebral Hemorrhage, Dijon Stroke Registry (2006–2017) |
| title_full | Atrial Fibrillation in Spontaneous Intracerebral Hemorrhage, Dijon Stroke Registry (2006–2017) |
| title_fullStr | Atrial Fibrillation in Spontaneous Intracerebral Hemorrhage, Dijon Stroke Registry (2006–2017) |
| title_full_unstemmed | Atrial Fibrillation in Spontaneous Intracerebral Hemorrhage, Dijon Stroke Registry (2006–2017) |
| title_short | Atrial Fibrillation in Spontaneous Intracerebral Hemorrhage, Dijon Stroke Registry (2006–2017) |
| title_sort | atrial fibrillation in spontaneous intracerebral hemorrhage dijon stroke registry 2006 2017 |
| topic | anticoagulants atrial fibrillation epidemiology intracerebral hemorrhage outcomes |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.020040 |
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