Related factors of ischemic stroke in elderly patients with atrial fibrillation

Chen Xiaoli; Pang Xingxue; Fan Yanqin; Liu Hong; Wang Yuan; Bai Ying; Luo Zhi

doi:10.3760/cma.j.issn.1673-4777.2015.09.006

Abstract：Objective To investigate the risk factors of ischemic stroke in elderly patients with atrial fibrillation.Methods Totally 268 elderly patients with atrial fibrillation who had no history of stroke from January 2011 to December 2012 were enrolled.The general data were collected.Taking stroke as endpoint event,all patients were followed up to the endpoint.The risk factors of ischemic stroke were analyzed.Results After 2 years of follow-up,ischemic stroke occurred in 36 patients,with overall incidence of 13.4％.The incidence of ischemic stroke in ＞ 75 years old patients was obviously higher than that in ≤75 years old patients [20.7％ (24/116) vs 7.9％ (12/152),x2 =9.26,P ＜0.05].The incidence of ischemic stroke in patients with diabetes and dyslipidemia were obviously higher than that in patients without diabetes and dyslipidemia [25.0％ (23/92) vs 7.4％ (13/176),18.8％ (22/117) vs 9.3％ (14/151)] (x2 =16.12,5.94,P ＜ 0.05).The incidence rates of ischemic stroke in patients with persistent atrial fibrillation was significantly higher than that in patients with paroxysmal atrial fibrillation [19.1％ (31/162) vs 4.7％ (5/106)] (x2 =11.45,P ＜0.01) ; the incidence of ischemic stroke in patients with valvular atrial fibrillation was obviously higher than in patients with nonvalvular atrial fibrillation [18.2％ (28/154) vs 7.0％ (8/114)] (x2 =7.02,P ＜ 0.01).Multivariate Logistic analysis showed that the age,diabetes,peripheral vascular disease,smoking and without anticoagulation therapy were independent risk factors of ischemic stroke in elderly patients with atrial fibrillation (OR =1.308,2.227,2.704,1.554,3.248).Conclusions Age,diabetes,peripheral vascular disease,smoking and without anticoagulation therapy were independent risk factors of ischemic stroke in elderly patients with atrial fibrillation.