Race Significantly Affects Stroke Risk in AF Patients

Black patients have a higher risk for ischemic stroke before and after a diagnosis of atrial fibrillation (AF) compared with white patients, according to a new study.

In the Penn Atrial Fibrillation Free study, the researchers assessed 3507 of 36,835 patients enrolled in the University of Pennsylvania Health System who were without AF and any history of stroke at baseline.
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Overall, 538 patients had experienced ischemic stroke and 54 had experienced hemorrhagic stroke. The researchers found that 254 (47%) of ischemic strokes occurred within 6 months prior to an AF diagnosis, and the majority of these strokes occurred either on the day of (n = 158) or within 7 days prior to a diagnosis of incident AF (n = 30). The remaining 284 (53%) ischemic stroke occurred a median of 3.6 years post-AF diagnosis.

Ultimately, black patients demonstrated an independently higher risk of ischemic stroke before (adjusted odds ratio 1.37) or after a diagnosis of AF (adjusted hazard ratio 1.67).

“In the population with incident AF, nearly half of the ischemic strokes occurred before the diagnosis of AF,” the researchers concluded. “Compared with whites, blacks had a higher risk of developing an ischemic stroke that persisted whether the stroke occurred in the period either before or after AF diagnosis.”

—Christina Vogt

Reference:

Patel PJ, Katz R, Borovskiy Y, et al. Race and stroke in an atrial fibrillation inception cohort: findings from the Penn Atrial Fibrillation Free study [Published online February 19, 2018]. Heart Rhythm. https://doi.org/10.1016/j.hrthm.2017.11.025.