• Stroke · May 2014

    Age dependence of risk factors for stroke and death in young patients with atrial fibrillation: a nationwide study.

    • Line Melgaard, Lars Hvilsted Rasmussen, Flemming Skjøth, Gregory Y H Lip, and Torben Bjerregaard Larsen.
    • From the Department of Cardiology, Atrial Fibrillation Study Group, Aalborg University Hospital, Aalborg, Denmark (L.M., F.S.T.B.L); Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Faculty of Health, Aalborg University, Aalborg, Denmark (L.H.R., F.S., G.Y.H.L., T.B.L.); and University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK (G.Y.H.L.).
    • Stroke. 2014 May 1; 45 (5): 1331-7.

    Background And PurposeThe risk of stroke and death in patients with atrial fibrillation is strongly associated with age and concomitant comorbidities. The aim of this study was to examine the age dependence of risk factors for stroke and mortality in young patients with atrial fibrillation.MethodsThis study is a population-based cohort study of 30- to 65-year-old patients with atrial fibrillation and diagnosed during 2000 to 2011, identified by record linkage between nationwide Danish registries. Cox regression models were used to estimate the risk of stroke and mortality according to risk factors within age groups: 30 to 50, 50 to 65, and 65 to 75 years.ResultsWe identified 73,799 nonvalvular atrial fibrillation patients, of which 37,782 (51.2%) were <65 years old (mean age 62.8). A higher modified cardiac failure or dysfunction, hypertension, age 75 (doubled), diabetes, stroke (doubled), vascular disease, age 65-74 and sex category (female) score (CHA2DS2-VASc score) was associated with decreased survival probability in all age groups. The overall incidence of stroke per year for 1 year (5 years) follow-up was 1.2% (0.6%), 3.5% (1.6%), and 5.6% (2.8%), respectively, for the age groups of 30 to 50, 50 to 65, and 65 to 75. Overall, risk factors such as previous stroke, heart failure, vascular disease, diabetes mellitus, and hypertension remained independent predictors of stroke and death in patients<65 years old with nonvalvular atrial fibrillation.ConclusionsThe CHA2DS2-VASc score is an applicable tool for all age groups and in nonvalvular atrial fibrillation patients<65 years old, the same risk factors apply.

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