Large Burden of Stroke Incidence in People with Cardiac Disease: A Linked Data Cohort Study
Keira Robinson,1 Judith M Katzenellenbogen,1 Timothy J Kleinig,2 Joosup Kim,3,4 Charley A Budgeon,1 Amanda G Thrift,4 Lee Nedkoff1,5 1School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia; 2Department of Neurology, Royal Adelaide Hospital, A...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-02-01
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| Series: | Clinical Epidemiology |
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| Online Access: | https://www.dovepress.com/large-burden-of-stroke-incidence-in-people-with-cardiac-disease-a-link-peer-reviewed-fulltext-article-CLEP |
| _version_ | 1797903216001679360 |
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| author | Robinson K Katzenellenbogen JM Kleinig TJ Kim J Budgeon CA Thrift AG Nedkoff L |
| author_facet | Robinson K Katzenellenbogen JM Kleinig TJ Kim J Budgeon CA Thrift AG Nedkoff L |
| author_sort | Robinson K |
| collection | DOAJ |
| description | Keira Robinson,1 Judith M Katzenellenbogen,1 Timothy J Kleinig,2 Joosup Kim,3,4 Charley A Budgeon,1 Amanda G Thrift,4 Lee Nedkoff1,5 1School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia; 2Department of Neurology, Royal Adelaide Hospital, Adelaide, South Australia, Australia; 3Department of Medicine, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; 4Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia; 5Victor Chang Cardiac Research Institute, Sydney, New South Wales, AustraliaCorrespondence: Keira Robinson, School of Population and Global Health, The University of Western Australia, M431, 35 Stirling Hwy, Crawley, WA, 6009, Australia, Email keira.robinson@uwa.edu.auPurpose: People with cardiac disease have 2– 4 times greater risk of stroke than the general population. We measured stroke incidence in people with coronary heart disease (CHD), atrial fibrillation (AF) or valvular heart disease (VHD).Methods: We used a person-linked hospitalization/mortality dataset to identify all people hospitalized with CHD, AF or VHD (1985– 2017), and stratified them as pre-existing (hospitalized 1985– 2012 and alive at October 31, 2012) or new (first-ever cardiac hospitalization in the five-year study period, 2012– 2017). We identified first-ever strokes occurring from 2012 to 2017 in patients aged 20– 94 years and calculated age-specific and age-standardized rates (ASR) for each cardiac cohort.Results: Of the 175,560 people in the cohort, most had CHD (69.9%); 16.3% had multiple cardiac conditions. From 2012– 17, 5871 first-ever strokes occurred. ASRs were greater in females than males in single and multiple condition cardiac groups, largely driven by rates in females aged ≥ 75 years, with stroke incidence in this age group being at least 20% greater in females than males in each cardiac subgroup. In females aged 20– 54 years, stroke incidence was 4.9-fold greater in those with multiple versus single cardiac conditions. This differential declined with increasing age. Non-fatal stroke incidence was greater than fatal stroke in all age groups except in the 85– 94 age group. Incidence rate ratios were up to 2-fold larger in new versus pre-existing cardiac disease.Conclusion: Stroke incidence in people with cardiac disease is substantial, with older females, and younger patients with multiple cardiac conditions, at elevated risk. These patients should be specifically targeted for evidence-based management to minimize the burden of stroke.Keywords: stroke incidence, coronary heart disease, valvular heart disease, atrial fibrillation, cardiac disease, risk factors |
| first_indexed | 2024-04-10T09:29:23Z |
| format | Article |
| id | doaj.art-fe503d1aa4f941df9b937a4039434d0c |
| institution | Directory Open Access Journal |
| issn | 1179-1349 |
| language | English |
| last_indexed | 2024-04-10T09:29:23Z |
| publishDate | 2023-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Epidemiology |
| spelling | doaj.art-fe503d1aa4f941df9b937a4039434d0c2023-02-19T13:56:56ZengDove Medical PressClinical Epidemiology1179-13492023-02-01Volume 1520321181733Large Burden of Stroke Incidence in People with Cardiac Disease: A Linked Data Cohort StudyRobinson KKatzenellenbogen JMKleinig TJKim JBudgeon CAThrift AGNedkoff LKeira Robinson,1 Judith M Katzenellenbogen,1 Timothy J Kleinig,2 Joosup Kim,3,4 Charley A Budgeon,1 Amanda G Thrift,4 Lee Nedkoff1,5 1School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia; 2Department of Neurology, Royal Adelaide Hospital, Adelaide, South Australia, Australia; 3Department of Medicine, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; 4Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia; 5Victor Chang Cardiac Research Institute, Sydney, New South Wales, AustraliaCorrespondence: Keira Robinson, School of Population and Global Health, The University of Western Australia, M431, 35 Stirling Hwy, Crawley, WA, 6009, Australia, Email keira.robinson@uwa.edu.auPurpose: People with cardiac disease have 2– 4 times greater risk of stroke than the general population. We measured stroke incidence in people with coronary heart disease (CHD), atrial fibrillation (AF) or valvular heart disease (VHD).Methods: We used a person-linked hospitalization/mortality dataset to identify all people hospitalized with CHD, AF or VHD (1985– 2017), and stratified them as pre-existing (hospitalized 1985– 2012 and alive at October 31, 2012) or new (first-ever cardiac hospitalization in the five-year study period, 2012– 2017). We identified first-ever strokes occurring from 2012 to 2017 in patients aged 20– 94 years and calculated age-specific and age-standardized rates (ASR) for each cardiac cohort.Results: Of the 175,560 people in the cohort, most had CHD (69.9%); 16.3% had multiple cardiac conditions. From 2012– 17, 5871 first-ever strokes occurred. ASRs were greater in females than males in single and multiple condition cardiac groups, largely driven by rates in females aged ≥ 75 years, with stroke incidence in this age group being at least 20% greater in females than males in each cardiac subgroup. In females aged 20– 54 years, stroke incidence was 4.9-fold greater in those with multiple versus single cardiac conditions. This differential declined with increasing age. Non-fatal stroke incidence was greater than fatal stroke in all age groups except in the 85– 94 age group. Incidence rate ratios were up to 2-fold larger in new versus pre-existing cardiac disease.Conclusion: Stroke incidence in people with cardiac disease is substantial, with older females, and younger patients with multiple cardiac conditions, at elevated risk. These patients should be specifically targeted for evidence-based management to minimize the burden of stroke.Keywords: stroke incidence, coronary heart disease, valvular heart disease, atrial fibrillation, cardiac disease, risk factorshttps://www.dovepress.com/large-burden-of-stroke-incidence-in-people-with-cardiac-disease-a-link-peer-reviewed-fulltext-article-CLEPstroke incidencecoronary heart diseasevalvular heart diseaseatrial fibrillationcardiac diseaserisk factors |
| spellingShingle | Robinson K Katzenellenbogen JM Kleinig TJ Kim J Budgeon CA Thrift AG Nedkoff L Large Burden of Stroke Incidence in People with Cardiac Disease: A Linked Data Cohort Study Clinical Epidemiology stroke incidence coronary heart disease valvular heart disease atrial fibrillation cardiac disease risk factors |
| title | Large Burden of Stroke Incidence in People with Cardiac Disease: A Linked Data Cohort Study |
| title_full | Large Burden of Stroke Incidence in People with Cardiac Disease: A Linked Data Cohort Study |
| title_fullStr | Large Burden of Stroke Incidence in People with Cardiac Disease: A Linked Data Cohort Study |
| title_full_unstemmed | Large Burden of Stroke Incidence in People with Cardiac Disease: A Linked Data Cohort Study |
| title_short | Large Burden of Stroke Incidence in People with Cardiac Disease: A Linked Data Cohort Study |
| title_sort | large burden of stroke incidence in people with cardiac disease a linked data cohort study |
| topic | stroke incidence coronary heart disease valvular heart disease atrial fibrillation cardiac disease risk factors |
| url | https://www.dovepress.com/large-burden-of-stroke-incidence-in-people-with-cardiac-disease-a-link-peer-reviewed-fulltext-article-CLEP |
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