Female sex was inconsistently associated with stroke risk , whereas the evidence was inconclusive that either heart failure or coronary artery disease is independently predictive of stroke .
Conclusions : Four clinical features ( prior stroke/TIA , advancing age , hypertension , diabetes ) are consistent independent risk factors for stroke in atrial fibrillation patients .
Background : Absolute stroke rates vary widely among patients with nonvalvular atrial fibrillation .
To balance the benefits and risks of chronic antithrombotic prophylaxis , it is important to estimate the absolute risk of stroke for individual patients .
Efficacy of anticoagulation for secondary stroke prevention in older people with non-valvular atrial fibrillation: a prospective case series study.
BACKGROUND AND PURPOSE Despite large r and omised trials that demonstrated the efficacy of oral anticoagulants in the primary and secondary prevention of stroke in patients with non-valvular atrial fibrillation ( AF ) , anticoagulation therapy remains largely under-used in older patients , who are at risk of first ever or recurrent stroke . The aim of the present study was to assess the influence of anticoagulation therapy on long-term prognosis in the oldest old stroke patients with AF after adjusting for baseline risk factors . METHODS We evaluated prospect ively a consecutive series of 207 older people ( > 75 years ) with AF and first ever ischaemic stroke . During the follow-up period ( mean 88.4 months , range 3 - 120 ) , the study population was under either oral anticoagulants ( n = 72 ) or aspirin ( n = 135 ) . Death and recurrent vascular events ( stroke and systemic embolism ) were documented . Statistical analyses were performed by means of the Kaplan-Meier product limit method and the Cox proportional hazards model . RESULTS The cumulative 10 year mortality and recurrence rate were 92.5 % ( 95 % CI 85.7 - 99.3 ) and 66.1 % ( 95 % CI 43.1 - 89.1 ) , respectively . Cox regression analysis revealed increasing age , functional dependency at hospital discharge and antiplatelet versus anticoagulation therapy as independent determinants of mortality . Antiplatelet versus anticoagulation therapy was the sole determinant of vascular recurrence .  Anticoagulation was associated with decreased risk of death ( hazards ratio ( HR ) 0.47 , 95 % CI 0.31 - 0.72 , P = 0.001 ) ) and recurrent thromboembolism ( HR 0.31 , 95 % CI 0.16 - 0.62 , P = 0.002 ) . CONCLUSIONS Our results suggest that the benefits of anticoagulation for secondary stroke prevention in AF patients extend to the oldest old . Prospect i ve r and omised clinical trials are needed to verify the potential benefit of anticoagulation in such patients
Female sex was inconsistently associated with stroke risk , whereas the evidence was inconclusive that either heart failure or coronary artery disease is independently predictive of stroke .
Conclusions : Four clinical features ( prior stroke/TIA , advancing age , hypertension , diabetes ) are consistent independent risk factors for stroke in atrial fibrillation patients .
Background : Absolute stroke rates vary widely among patients with nonvalvular atrial fibrillation .
To balance the benefits and risks of chronic antithrombotic prophylaxis , it is important to estimate the absolute risk of stroke for individual patients .