Risk of Atrial Fibrillation, Ischemic Stroke and Cognitive Impairment : Study of a Population Cohort ≥65 Years of Age
Clua Espuny, Jose Luis (Universitat Rovira i Virgili)
Muria-Subirats, Eulalia (Institut Català de la Salut)
Ballesta-Ors, Juan (Universitat Rovira i Virgili)
Lorman-Carbo, Blanca (Institut Català de la Salut)
Clua-Queralt, Josep (Universitat de Lleida)
Palà, Elena (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Lechuga-Duran, Iñigo (Hospital de Tortosa Verge de la Cinta)
Gentille-Lorente, Delicia (Hospital de Tortosa Verge de la Cinta)
Bustamante, Alejandro (Hospital Universitari Vall d'Hebron)
Muñoz, Miguel-Angel (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Montaner, Joan (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Universitat Autònoma de Barcelona

Data:	2020
Resum:	To evaluate a model for calculating the risk of AF and its relationship with the incidence of ischemic stroke and prevalence of cognitive decline. It was a multicenter, observational, retrospective, community-based study of a cohort of general population ≥6ct 35 years, between 01/01/2016 and 31/12/2018. Setting: Primary Care. Participants: 46,706 people ≥65 years with an active medical history in any of the primary care teams of the territory, information accessible through shared history and without previous known AF. Interventions: The model to stratify the risk of AF (PI) has been previously published and included the variables sex, age, mean heart rate, mean weight and CHA2DS2VASc score. Main measurements: For each risk group, the incidence density/1000 person/years of AF and stroke, number of cases required to detect a new AF, the prevalence of cognitive decline, Kendall correlation, and ROC curve were calculated. The prognostic index was obtained in 37,731 cases (80. 8%) from lowest (Q1) to highest risk (Q4). A total of 1244 new AFs and 234 stroke episodes were diagnosed. Q3-4 included 53. 8% of all AF and 69. 5% of strokes in men; 84. 2% of all AF and 85. 4% of strokes in women; and 77. 4% of cases of cognitive impairment. There was a significant linear correlation between the risk-AF score and the Rankin score (p < 0. 001), the Pfeiffer score (p < 0. 001), but not NIHSS score (p 0. 150). The overall NNS was 1/19. Risk stratification allows identifying high-risk individuals in whom to intervene on modifiable risk factors, prioritizing the diagnosis of AF and investigating cognitive status.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Vascular risk score ; Atrial arrhythmia ; Cerebrovascular disease ; Silent stroke ; Cognitive decline
Publicat a:	Vascular Health and Risk Management, Vol. 16 (october 2020) , p. 445-454, ISSN 1178-2048

DOI: 10.2147/VHRM.S276477
PMID: 33149596

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