Comparison of stroke risk according to sinus node disease, atrial fibrillation and bradycardia-tachycardia syndrome: A French nationwide cohort-study

Autor: L Fauchier, Alexandre Bodin, F Mondout, Bertrand Pierre, Dominique Babuty, C Gaborit, Clémentine André, Arnaud Bisson, Nicolas Clementy
Rok vydání: 2019
Předmět:
Zdroj: Archives of Cardiovascular Diseases Supplements. 11:119
ISSN: 1878-6480
DOI: 10.1016/j.acvdsp.2018.10.263
Popis: Background Atrial fibrillation (AF) may commonly be associated with sinus node disease (SND) presenting as the so-called bray-tachy syndrome (BTS). BTS and AF are known to be at risk for ischemic stroke (IS). It remains unclear whether the risk of IS is similar in patients with isolated SND. Purpose Our objective was to compare the risk of IS in AF, SND and BTS patients and to identify risk factors of stroke in patients with SND. Methods This French longitudinal cohort study was based on the national hospitalization database, the Programme de medicalisation des systemes d’information (PMSI). We included all patients over 18 y.o. in France from January 2010 to December 2015 hospitalized with a main or related diagnosis of AF or SND. Baseline characteristics were pooled into a multivariate Cox model to identify significant predictors of IS. Results Of 1,732,412 patients included after exclusion of pacemaker or implantable cardiac defibrillator patients (PM/ICD), 1,601,435 (92.44%) had AF, 102,849 (5.94%) SND and 28,128 (1.62%) BTS. Compared to patients with AF or BTS, those with SND were younger, had a lower CHA2DS2-VASc score. Incidence of IS during follow-up was higher in AF than in BTS patients (yearly rate 4.90% vs. 2.73%, P Conclusion Patients with SND have a lower risk of thromboembolic events than those with AF or BTS. However, SND patients with a CHA2DS2-VASc score ≥ 2 had a markedly higher risk of IS during follow-up and may need specific considerations.
Databáze: OpenAIRE
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