Supplementary results for stroke, timing of atrial fibrillation diagnosis, and risk of death

Objective:  To evaluate the prognosis of ischemic stroke patients according to the timing of an atrial fibrillation (AF) diagnosis, we created an inception cohort of incident stroke events and compared the risk of death between stroke patients with a) sinus rhythm; b) known atrial fibrillation (KAF); and c) AF diagnosed after stroke (AFDAS). 

Methods:  We utilized the Penn AF Free study to create an inception cohort of patients with incident stroke.  Mortality events were identified after linkage with the National Death Index through June 30, 2017.  We also evaluated initiation of anticoagulants and antiplatelets across the study duration.  Cox proportional hazards models evaluated associations between stroke subtypes and death.

Results:  We identified 1,489 individuals who developed an incident ischemic stroke event:  985 did not develop AF at any point during the study period, 215 had KAF before stroke, 160 had AF detected ≤6 months after stroke and 129 had AF detected >6 mon...

研究目标：为根据心房颤动（atrial fibrillation, AF）的确诊时间评估缺血性脑卒中（ischemic stroke）患者的预后，我们构建了首发卒中事件的起始队列，对比了三类卒中患者的死亡风险：a）窦性心律患者；b）已知心房颤动（known atrial fibrillation, KAF）患者；c）卒中后确诊心房颤动（AF diagnosed after stroke, AFDAS）患者。

研究方法：本研究依托宾夕法尼亚无心房颤动研究（Penn AF Free study）构建了首发卒中患者的起始队列。通过与国家死亡索引（National Death Index）进行数据关联，我们识别出截至2017年6月30日的所有死亡事件。同时，我们评估了研究周期内抗凝剂与抗血小板药物的启用情况。采用Cox比例风险模型（Cox proportional hazards models）分析卒中亚型与死亡之间的关联。

研究结果：本研究共纳入1489例首发缺血性脑卒中患者：其中985例在整个研究周期内均未发生心房颤动，215例在卒中发生前已确诊心房颤动，160例在卒中后≤6个月确诊心房颤动，另有129例在卒中后>6个月确诊心房颤动（原文后续内容未完整展示）。