Vascular Disease Tied to Higher Stroke or Death Risk in A-Fib

Peripheral artery disease and/or myocardial infarction independently tied to increased risk

THURSDAY, July 14 (HealthDay News) -- The presence of a vascular disease, either peripheral artery disease (PAD) or prior myocardial infarction (MI), or both, is associated with increased risk of stroke or death in patients with atrial fibrillation (AF), independent of Cardiac failure, Hypertension, Age, Diabetes, Stroke (doubled) (CHADS2) risk score, according to a study published in the July issue of the Journal of Thrombosis and Haemostasis.

Lars Hvilsted Rasmussen, M.D., Ph.D., from Aarhus University Hospital in Denmark, and colleagues investigated the impact of vascular disease on the risk of stroke or death in 3,315 patients (2,130 men and 1,185 women), with a mean age of 67.1 years, with incident AF. Data were collected and analyzed from participants of the Danish Diet, Cancer, and Health study who were followed up for an average of 4.8 years. Incident stroke or death were the primary end points of the study.

The investigators found that 12.6 percent of the patients with AF had PAD or prior incidence of MI or both. Patients with vascular disease at the one-year follow-up had a significantly higher risk of stroke or death (crude hazard ratio [HR], 2.51; crude HR, 3.51 and 1.99 for PAD and MI, respectively). Individual risk estimates for death or stroke were similar (crude HR, 2.48 and 1.77, respectively). For patients with vascular disease, the CHADS2 risk factors-adjusted HR for stroke or death was 1.91, and for death was 1.97.

"Vascular disease (prior MI and PAD) is an independent risk factor for the primary end point of 'stroke or death' in patients with AF, even after adjustment for the CHADS2 risk score," the authors write.

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