 |
|
Lone Atrial Fibrillation in Elderly Persons
A Marker for Cardiovascular Risk
Stephen L. Kopecky, MD;
Bernard J. Gersh, MB, ChB, DPhil;
Michael D. McGoon, MD;
Chu-Pin Chu, BS;
Duane M. Ilstrup, MS;
James H. Chesebro, MD;
Jack P. Whisnant, MD
Arch Intern Med. 1999;159:1118-1122.
Background The risk of stroke in persons aged 60 years and younger with lone atrial fibrillation (LAF) is no greater than in the general population. The effect of older age on the risk of stroke in persons with LAF is less well established.
Participants and Methods The risk of stroke in persons with LAF and without substantial comorbidities was examined in a population-based study at a single institution in Olmsted County, Minnesota, and compared with that in an age- and sex-matched population. The mean age was 74 years (range, 61-97 years). The median duration of follow-up was 9.6 years until death or last follow-up.
Results Of 55 patients, 26 had 31 cardiovascular events during follow-up, occurring a median of 5.1 years after diagnosis (range, 0.7-18 years). Of 11 cerebrovascular events, 6 were transient ischemic attacks and 5 were strokes. The event rates (percentage per person-year) were 0.9% for stroke, 1.1% for transient cerebral ischemia, and 2.6% for myocardial infarction, for a total cardiovascular event rate of 5.0% per person-year. The corresponding rates for the age- and sex-matched control group were 0.2%, 0%, and 1.1%, for a total of 1.3% per person-year. The incidence of total cardiovascular events was significantly greater (P<.01) in those with LAF, although there was no difference in survival.
Conclusion Lone atrial fibrillation occurring after age 60 years is a risk marker for a substantial increase in cardiovascular events that warrants consideration for antithrombotic therapy.
From the Division of Cardiovascular Diseases and Internal Medicine (Drs Kopecky, Gersh, McGoon, and Chesebro), the Departments of Health Sciences Research and Neurology (Dr Whisnant), and the Section of Biostatistics (Ms Chu and Mr Ilstrup), Mayo Clinic and Mayo Foundation, Rochester, Minn. Dr Chesebro is now with the Division of Cardiology, Mount Sinai Medical Center, New York, NY.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
RELATED ARTICLE
Archives of Internal Medicine Reader's Choice: Continuing Medical Education
Arch Intern Med. 1999;159(10):1146-1147.
FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Warfarin Use Associates with Increased Risk for Stroke in Hemodialysis Patients with Atrial Fibrillation
Chan et al.
J. Am. Soc. Nephrol. 2009;20:2223-2233.
ABSTRACT
| FULL TEXT
Prevention of recurrent lone atrial fibrillation by the angiotensin-II converting enzyme inhibitor ramipril in normotensive patients.
Belluzzi et al.
J Am Coll Cardiol 2009;53:24-29.
ABSTRACT
| FULL TEXT
Impact of telemonitoring at home on the management of elderly patients with congestive heart failure
Antonicelli et al.
J Telemed Telecare 2008;14:300-305.
ABSTRACT
| FULL TEXT
New risk factors for atrial fibrillation: causes of 'not-so-lone atrial fibrillation'
Schoonderwoerd et al.
Europace 2008;10:668-673.
ABSTRACT
| FULL TEXT
Lone Atrial Fibrillation: Good, Bad, or Ugly?
Frost
Circulation 2007;115:3040-3041.
FULL TEXT
Long-Term Progression and Outcomes With Aging in Patients With Lone Atrial Fibrillation: A 30-Year Follow-Up Study
Jahangir et al.
Circulation 2007;115:3050-3056.
ABSTRACT
| FULL TEXT
The progressive nature of atrial fibrillation: a rationale for early restoration and maintenance of sinus rhythm
Van Gelder and Hemels
Europace 2006;8:943-949.
ABSTRACT
| FULL TEXT
Abnormalities of pulmonary venous flow in patients with lone atrial fibrillation.
Kosmala et al.
Europace 2006;8:102-106.
ABSTRACT
| FULL TEXT
Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up
Osranek et al.
Eur Heart J 2005;26:2556-2561.
ABSTRACT
| FULL TEXT
Selecting Patients With Atrial Fibrillation for Anticoagulation: Stroke Risk Stratification in Patients Taking Aspirin
Gage et al.
Circulation 2004;110:2287-2292.
ABSTRACT
| FULL TEXT
The Natural History of Lone Atrial Flutter
Halligan et al.
ANN INTERN MED 2004;140:265-268.
ABSTRACT
| FULL TEXT
Heart Failure Complicated by Atrial Fibrillation: Mechanistic, Prognostic, and Therapeutic Implications
Gronefeld and Hohnloser
J CARDIOVASC PHARMACOL THER 2003;8:107-113.
ABSTRACT
Emergency management of atrial fibrillation
Wakai and O'Neill
Postgrad. Med. J. 2003;79:313-319.
ABSTRACT
| FULL TEXT
Validation of Clinical Classification Schemes for Predicting Stroke: Results From the National Registry of Atrial Fibrillation
Gage et al.
JAMA 2001;285:2864-2870.
ABSTRACT
| FULL TEXT
Atrial Fibrillation
Falk
NEJM 2001;344:1067-1078.
FULL TEXT
Epidemiology and natural history of atrial fibrillation: clinical implications
Chugh et al.
J Am Coll Cardiol 2001;37:371-378.
ABSTRACT
| FULL TEXT
|
