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Temporal relations between atrial fibrillation and ischaemic stroke and their prognostic impact on mortality

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Camen, S, Ojeda, FM, Niiranen, T, Gianfagna, F, Vishram-Nielsen, JK, Costanzo, S, Söderberg, S, Vartiainen, E, Donati, MB, Løchen, M-L, Pasterkamp, G, Magnussen, C, Kee, F, Jousilahti, P, Hughes, M, Kontto, J, Mathiesen, EB, Koenig, W, Palosaari, T, Blankenberg, S, de Gaetano, G, Jørgensen, T, Zeller, T, Kuulasmaa, K, Linneberg, A, Salomaa, V, Iacoviello, L & Schnabel, RB 2020, 'Temporal relations between atrial fibrillation and ischaemic stroke and their prognostic impact on mortality' Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. https://doi.org/10.1093/europace/euz312

APA

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Camen S, Ojeda FM, Niiranen T, Gianfagna F, Vishram-Nielsen JK, Costanzo S, Söderberg S, Vartiainen E, Donati MB, Løchen M-L, Pasterkamp G, Magnussen C, Kee F, Jousilahti P, Hughes M, Kontto J, Mathiesen EB, Koenig W, Palosaari T, Blankenberg S, de Gaetano G, Jørgensen T, Zeller T, Kuulasmaa K, Linneberg A, Salomaa V, Iacoviello L, Schnabel RB. 2020. Temporal relations between atrial fibrillation and ischaemic stroke and their prognostic impact on mortality. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. https://doi.org/10.1093/europace/euz312

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Author

Camen, Stephan ; Ojeda, Francisco M ; Niiranen, Teemu ; Gianfagna, Francesco ; Vishram-Nielsen, Julie K ; Costanzo, Simona ; Söderberg, Stefan ; Vartiainen, Erkki ; Donati, Maria Benedetta ; Løchen, Maja-Lisa ; Pasterkamp, Gerard ; Magnussen, Christina ; Kee, Frank ; Jousilahti, Pekka ; Hughes, Maria ; Kontto, Jukka ; Mathiesen, Ellisiv B ; Koenig, Wolfgang ; Palosaari, Tarja ; Blankenberg, Stefan ; de Gaetano, Giovanni ; Jørgensen, Torben ; Zeller, Tanja ; Kuulasmaa, Kari ; Linneberg, Allan ; Salomaa, Veikko ; Iacoviello, Licia ; Schnabel, Renate B. / Temporal relations between atrial fibrillation and ischaemic stroke and their prognostic impact on mortality. I: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2020.

Bibtex

@article{a7b49bd9209a4c07b51a845cff6874db,
title = "Temporal relations between atrial fibrillation and ischaemic stroke and their prognostic impact on mortality",
abstract = "AIMS: Limited evidence is available on the temporal relationship between atrial fibrillation (AF) and ischaemic stroke and their impact on mortality in the community. We sought to understand the temporal relationship of AF and ischaemic stroke and to determine the sequence of disease onset in relation to mortality.METHODS AND RESULTS: Across five prospective community cohorts of the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) project we assessed baseline cardiovascular risk factors in 100 132 individuals, median age 46.1 (25th-75th percentile 35.8-57.5) years, 48.4{\%} men. We followed them for incident ischaemic stroke and AF and determined the relation of subsequent disease diagnosis with overall mortality. Over a median follow-up of 16.1 years, N = 4555 individuals were diagnosed solely with AF, N = 2269 had an ischaemic stroke but no AF diagnosed, and N = 898 developed both, ischaemic stroke and AF. Temporal relationships showed a clustering of diagnosis of both diseases within the years around the diagnosis of the other disease. In multivariable-adjusted Cox regression analyses with time-dependent covariates subsequent diagnosis of AF after ischaemic stroke was associated with increased mortality [hazard ratio (HR) 4.05, 95{\%} confidence interval (CI) 2.17-7.54; P < 0.001] which was also apparent when ischaemic stroke followed after the diagnosis of AF (HR 3.08, 95{\%} CI 1.90-5.00; P < 0.001).CONCLUSION: The temporal relations of ischaemic stroke and AF appear to be bidirectional. Ischaemic stroke may precede detection of AF by years. The subsequent diagnosis of both diseases significantly increases mortality risk. Future research needs to investigate the common underlying systemic disease processes.",
author = "Stephan Camen and Ojeda, {Francisco M} and Teemu Niiranen and Francesco Gianfagna and Vishram-Nielsen, {Julie K} and Simona Costanzo and Stefan S{\"o}derberg and Erkki Vartiainen and Donati, {Maria Benedetta} and Maja-Lisa L{\o}chen and Gerard Pasterkamp and Christina Magnussen and Frank Kee and Pekka Jousilahti and Maria Hughes and Jukka Kontto and Mathiesen, {Ellisiv B} and Wolfgang Koenig and Tarja Palosaari and Stefan Blankenberg and {de Gaetano}, Giovanni and Torben J{\o}rgensen and Tanja Zeller and Kari Kuulasmaa and Allan Linneberg and Veikko Salomaa and Licia Iacoviello and Schnabel, {Renate B}",
note = "Published on behalf of the European Society of Cardiology. All rights reserved. {\circledC} The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.",
year = "2020",
doi = "10.1093/europace/euz312",
language = "English",
journal = "Europace",
issn = "1099-5129",
publisher = "Oxford University Press",

}

RIS

TY - JOUR

T1 - Temporal relations between atrial fibrillation and ischaemic stroke and their prognostic impact on mortality

AU - Camen, Stephan

AU - Ojeda, Francisco M

AU - Niiranen, Teemu

AU - Gianfagna, Francesco

AU - Vishram-Nielsen, Julie K

AU - Costanzo, Simona

AU - Söderberg, Stefan

AU - Vartiainen, Erkki

AU - Donati, Maria Benedetta

AU - Løchen, Maja-Lisa

AU - Pasterkamp, Gerard

AU - Magnussen, Christina

AU - Kee, Frank

AU - Jousilahti, Pekka

AU - Hughes, Maria

AU - Kontto, Jukka

AU - Mathiesen, Ellisiv B

AU - Koenig, Wolfgang

AU - Palosaari, Tarja

AU - Blankenberg, Stefan

AU - de Gaetano, Giovanni

AU - Jørgensen, Torben

AU - Zeller, Tanja

AU - Kuulasmaa, Kari

AU - Linneberg, Allan

AU - Salomaa, Veikko

AU - Iacoviello, Licia

AU - Schnabel, Renate B

N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.

PY - 2020

Y1 - 2020

N2 - AIMS: Limited evidence is available on the temporal relationship between atrial fibrillation (AF) and ischaemic stroke and their impact on mortality in the community. We sought to understand the temporal relationship of AF and ischaemic stroke and to determine the sequence of disease onset in relation to mortality.METHODS AND RESULTS: Across five prospective community cohorts of the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) project we assessed baseline cardiovascular risk factors in 100 132 individuals, median age 46.1 (25th-75th percentile 35.8-57.5) years, 48.4% men. We followed them for incident ischaemic stroke and AF and determined the relation of subsequent disease diagnosis with overall mortality. Over a median follow-up of 16.1 years, N = 4555 individuals were diagnosed solely with AF, N = 2269 had an ischaemic stroke but no AF diagnosed, and N = 898 developed both, ischaemic stroke and AF. Temporal relationships showed a clustering of diagnosis of both diseases within the years around the diagnosis of the other disease. In multivariable-adjusted Cox regression analyses with time-dependent covariates subsequent diagnosis of AF after ischaemic stroke was associated with increased mortality [hazard ratio (HR) 4.05, 95% confidence interval (CI) 2.17-7.54; P < 0.001] which was also apparent when ischaemic stroke followed after the diagnosis of AF (HR 3.08, 95% CI 1.90-5.00; P < 0.001).CONCLUSION: The temporal relations of ischaemic stroke and AF appear to be bidirectional. Ischaemic stroke may precede detection of AF by years. The subsequent diagnosis of both diseases significantly increases mortality risk. Future research needs to investigate the common underlying systemic disease processes.

AB - AIMS: Limited evidence is available on the temporal relationship between atrial fibrillation (AF) and ischaemic stroke and their impact on mortality in the community. We sought to understand the temporal relationship of AF and ischaemic stroke and to determine the sequence of disease onset in relation to mortality.METHODS AND RESULTS: Across five prospective community cohorts of the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) project we assessed baseline cardiovascular risk factors in 100 132 individuals, median age 46.1 (25th-75th percentile 35.8-57.5) years, 48.4% men. We followed them for incident ischaemic stroke and AF and determined the relation of subsequent disease diagnosis with overall mortality. Over a median follow-up of 16.1 years, N = 4555 individuals were diagnosed solely with AF, N = 2269 had an ischaemic stroke but no AF diagnosed, and N = 898 developed both, ischaemic stroke and AF. Temporal relationships showed a clustering of diagnosis of both diseases within the years around the diagnosis of the other disease. In multivariable-adjusted Cox regression analyses with time-dependent covariates subsequent diagnosis of AF after ischaemic stroke was associated with increased mortality [hazard ratio (HR) 4.05, 95% confidence interval (CI) 2.17-7.54; P < 0.001] which was also apparent when ischaemic stroke followed after the diagnosis of AF (HR 3.08, 95% CI 1.90-5.00; P < 0.001).CONCLUSION: The temporal relations of ischaemic stroke and AF appear to be bidirectional. Ischaemic stroke may precede detection of AF by years. The subsequent diagnosis of both diseases significantly increases mortality risk. Future research needs to investigate the common underlying systemic disease processes.

U2 - 10.1093/europace/euz312

DO - 10.1093/europace/euz312

M3 - Journal article

JO - Europace

JF - Europace

SN - 1099-5129

ER -

ID: 58409655