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To study atrial fibrillation as risk factor in elderly patients for ischemic stroke.
This cross section, hospital based, comparative study of different age groups was conducted at Departmentof Medicine, Unit 1, Jinnah Post Graduate Medical Centre, Karachi, Pakistan, January 2007 to June 2010 on 458(271 male and 187 female) patients with ischemic stroke. Patients above the age of 50 years with ischemic stroke werecategorized into four age groups. Other risk factors for stroke were also taken into consideration. Data were analyzedto determine age based relationship with atrial fibrillation.
Atrial fibrillation was observed in 190/458 patients (41.48%) above the age of 50 years who reported withischemic stroke Out of which 112 (58.95%) were male and 78 (41.05%) were female. Atrial fibrillation was observed tobe 11.20% in age group 50-59 years which increases to 39.85 % in the age group 60-69 years and 67.92% in the agegroup 70-79 years. It slightly drops to (61.11%) in the patients with more than 80 years age. No significant differencein these percentages was seen on the basis of gender. Observed through their medical record, other risk factors suchas hypertension, previous structural heart diseases, previous stroke and smoking were also having similar impact, frequencyof stroke in the elderly.
The study reveals that atrial fibrillation is a major risk factor for stroke in elderly patients.
Atrial Fibrillation, Stroke, Risk factors, Age-dependence, Hypertension, Smoking, Heart disease.
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Durrani MRK. Hospital based study on elderly patients in Karachi, Pakistan. Khyber MedUniv J 2012; 4(4): 193-196.
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epidemiology of stroke in Pakistan: past, present,
and future. Inter J Stroke 2009; 4: 381–9.
2. Kannel WB, Benjamin EJ. Status of the epidemiology
of atrial fibrillation. Med Clin North Am 2008;
3. Syed NA, Khealani BA, Ali S, Hasan A, Akhtar N, Brohi
H, et al. Ischemic stroke subtypes in Pakistan: The
Aga Khan University Stroke Data Bank. J Pak Med
Assoc 2003; 53: 584-8.
4. Jais P, Haissaguerre M, Shah DC, Chouairi S, Gencel
L, Hocini M, et al. A focal source of atrial fibrillation
treated by discrete radiofrequency ablation. Circulation
1997; 95: 572–576.
5. Moe GK, Rheinboldt WC, Abildskov JA. A computer
model of atrial fibrillation. Am Heart J 1964; 67: 200-
6. Daoud EJ, Knight BK, Weiss R, Bahu W, Paladino W,
Goyal R, et al. Effect of verapamil and procainamide
on atrial fibrillation–induced electrical remodeling in
humans. Circulation 1997; 96: 1542-50.
7. Bal S, Ojha P, Hill MD. Stroke prevention treatment of
patients with atrial fibrillation: old and new. Cur Neur
Neurosci Rep 2010; 11: 15-27.
8. Baruch L, Gage BL, Horrow B, Juul-Möller B, Labovitz
A, Persson M, et al. Can patients at elevated risk
of stroke treated with anticoagulants be further risk
stratified? Stroke 2007; 38: 2459-63.
9. Leong-Sit P, Zado E, Callans DJ, Garcia F, Lin D, Dixit
S, et al. Efficacy and risk of atrial fibrillation ablation
before 45 years of age. Circ Arrh Electrophy 2010;
10. Hart RG, Pearce LA. Current status of stroke risk
stratification in patients with atrial fibrillation. Stroke
2009; 40: 2607-10.
11. Kamal AK, Khealani BA, Ansari SA, Afridi M, Syed
NA, Early ischemic stroke presentation in Pakistan.
Canadian J Neur Sci 2009; 36: 181-6.
12. Marengoni A, Qiu C, Winblad B, Fratiglioni, L.
Atrial fibrillation, stroke and dementia in the very
old: A population-based study, Neurobiol Aging
13. Haider I , Khan A, Iqbal N, Subhan F, Muhammad I,
Ajmal F. Cardiac evaluation of patients with ischemic
stroke. Khyber Med Univ J 2012; 4(1): 9-12.
14. Safeer M, Tariq M, -Ubaid ur Rehman, Frequency of
risk factors of cerebral infarction in stroke patients.
A study of 100 cases in Naseer Teaching Hospital,
Peshawar. Pak J Med Sci 2008; 24: 109-13.
15. Basharat AR, Yousaf M. Frequency of known risk
factors for stroke in poor patients admitted to Lahore
General Hospital in 2000. Pak J Med Sci 2002; 18:
16. Alam I, Haider I, Wahab F, Khan W, Taqweem MA,
Nowsherwan, Risk factors stratification in 100 patients
of acute stroke. J Postgrad Med Inst 18: 583-91.
17. Khan SN, Vohra EA. Risk factors for stroke: A hospital
based study. Pak J Med Sci 2007; 23: 17-22.
18. Khan H, Afridi AK, Ashraf S. A hospital based study
on stratification of risk factors of strokes in Peshawar.
Pak J Med Sci 2006; 22: 304-7.
19. Hart RG, Palacio S, Pearce LA. Atrial fibrillation,
stroke, and acute antithrombotic therapy: Analysis of
randomized clinical trials. Stroke 2002; 33: 2722–7.
20. Marini M, De Santis F, Sacco S, Russo T, Olivieri L,
Totaro, R, et al. contribution of atrial fibrillation to incidence
and outcome of ischemic stroke: results from
a population-based study. Stroke 2005; 36: 1115-9.
21. Go AS, Hylek HM, Phillips, KA, Chang Y-C, Henault
LE, Selby JV, et al. Prevalence of diagnosed atrial
fibrillation in adults: national implications for rhythm
management and stroke prevention: the anticoagulation
and risk factors in atrial fibrillation (atria) study.
JAMA 2001; 285: 2370-5.
22. Halperin JL, Hart RG. Atrial fibrillation and stroke:
new ideas, persisting dilemmas. Stroke. 1988; 19:
23. Miller VT, Rothrock JF, Pearce LA, Feinberg WM, Hart
RG, Anderson DC. Ischemic stroke in patients with
atrial fibrillation: effect of aspirin according to stroke
mechanism. Neurology 1993; 43: 32–6.
24. van Walraven C, Hart RG, Connolly S, Austin PC, Mant
J, Hobbs R, et al. Effect of age on stroke prevention
therapy in patients with atrial fibrillation: The atrial
fibrillation investigators. Stroke 2009; 40: 1410-6.
25. Medi C, Hankey GJ, Freedman SB. Stroke Risk and
Antithrombotic Strategies in Atrial Fibrillation. Stroke
2010; 41: 2705-13.