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Is Atrial Fibrillation an Independent Risk Factor for Stroke?*

Published online by Cambridge University Press:  18 September 2015

Stephen J. Phillips
Stephen J. Phillips*
Affiliation:
Department of Medicine (Division of Neurology), Dalhousie University, and Camp Hill Medical Centre, Halifax, Nova Scotia
*
Camp Hill Medical Centre, Department of Medicine, Gerard Hall, 5303 Morris Street, Halifax, Nova Scotia, Canada B3J 1B6
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Abstract:

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That non-rheumatic atrial fibrillation is an independent risk factor for cerebral infarction has not been established with certainty. The rationale underlying contemporary clinical trials of warfarin therapy for the prevention of stroke in patients who have non-rheumatic atrial fibrillation is that the majority of strokes in such patients are due to cardiogenic cerebral embolism. However, there is evidence to suggest that the increased probability of stroke attributed to this arrhythmia is due to its association with other risk factors such as hypertension, diabetes mellitus, and atherosclerosis. The question of who should be anticoagulated is a major public health issue since atrial fibrillation is present in approximately ten per cent of the general population aged 65 or more years.

Résumé:

RÉSUMÉ:

Il n'a jamais été établi avec certitude que la fibrillation auriculaire d'origine non-rhumatismale soit un facteur de risque indépendant de l'infarcissement cérébral. La justification des essais thérapeutiques avec la warfarine pour la prévention des accidents cérébro-vasculaires (ACV) chez les patients qui ont une fibrillation auriculaire non-rhumatismale est que la majorité des ACV chez ces patients est due à une embolie cérébrale cardiogénique. Cependant, certaines données suggèrent que la probabilité accrue d'ACV attribuée à ce type d'arythmie est due à son association à d'autres facteurs de risque, tels l'hypertension, le diabète et l'athérosclérose. La question à savoir qui devrait être anticoagulé est un sujet de débat important en santé publique, car la fibrillation auriculaire est présente chez approximativement dix pourcent de la population générale âgée de 65 ans et plus.

Type
Special Features and Reviews
Information
Canadian Journal of Neurological Sciences , Volume 17 , Issue 2 , May 1990 , pp. 163 - 169
Copyright
Copyright © Canadian Neurological Sciences Federation 1990

Footnotes

*

Canadian Stroke Society Prize Essay, 1989

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