OR41. Hypertension and Abnormal Renal Function Increased the Risk of Ischemic Stroke in Anticoagulated EHRA type-1 Valvular Atrial Fibrillation. (23rd November 2021)

• Record Type: Journal Article
• Authors: Winanti, R; Raharjo, S B; Ariani, R; Hanafy, D A; Atmadikoesoemah, C A; Almazini, P
• Is Part Of: European heart journal supplements. Volume 23(2021)Supplement F
• Publication Date: 2021-11-23
• Subjects: EHRA type-1 valvular AF -- ischemic stroke -- hypertension -- abnormal renal function; Cardiology -- Periodicals; Cardiology -- Europe -- Periodicals; 616.12005
• DOI: 10.1093/eurheartjsupp/suab122.040
• Languages: English
• ISSNs: 1520-765X

Abstract

Abstract: Aims: Atrial fibrillation increases the risk of stroke substantially, many scores have been developed to risk stratify these patients. Most of the studies have focused on non-valvular AF. The most widely used risk stratification score is the CHA2DS2-VASC score. Unfortunately, the validation of this score in valvular AF is poor. This study aimed to evaluate the clinical factors and echocardiographic parameters related to the incidence of ischemic stroke in anticoagulated EHRA (Evaluated Heartvalves, Rheumatic or Artificial) type-1 valvular AF patients. Methods and Results: We conducted a retrospective cohort study based on data from the Indonesian Registry on Atrial Fibrillation (OneAF). Patients with EHRA type-1 valvular AF between January 2015 and December 2019 were analysed. The clinical outcome was an ischemic stroke that occurred during the monitoring period of January 2015 - December 2019. Among 329 AF patients with mitral stenosis or prosthetic heart valves, the incidence of ischemic stroke was 17 (5.2%). Multivariate logistic regression analysis showed that two clinical factors, i.e., history of hypertension (OR 5.59; 95% CI: 1.93-16.15; p= 0.001) and estimated Glomerular Filtration Rate (eGFR) ≤59 mL/min/m 2 (OR 3.62; 95% CI: 1.30-10.02; p= 0.013) were independently associated with the incidence of ischemic stroke. No echocardiographic parameters were associated with the incidence of ischemic stroke in this population. Conclusion: We observed that two clinical factors i.e., history of hypertension and abnormal renal function, were markedly associated with stroke incidence in anticoagulated EHRA type-1 valvular AF patients.