Table 2: Studies on Risk Factors for Residual Stroke in AF.
| Study | Year | Study design | Prospective or Retrospective | No. Patients | Follow-up Duration | Results |
|---|---|---|---|---|---|---|
| Szeto and Hui[29] | 2010 | Cohort study | Retrospective | 109 | 8 years | 65.1% female, mean age 78 years, 83.5% had hypertension |
| Lip et al.[33] | 2010 | Post hoc analysis of RCT | Retrospective | 7,329 | 1.5 years | Age ≥75 years (HR 1.77, 95% CI [1.32–2.38]), previous stroke or TIA (HR 2.24 [95% CI, 1.66–3.02]), coronary artery disease (HR 1.52, 95% CI [1.14–2.04]), smoking (HR 2.10, 95% CI [1.38–3.18]) and non-use of alcohol (HR 1.43, 95% CI [1.05–1.92]) were significant predictors of thromboembolism |
| Albertsen et al.[35] | 2013 | Meta-analysis of 6 RCTs | NA | 58,883 | NA | Age ≥75 years (RR 1.46, 95% CI [1.25–1.69]), female sex (RR 1.30, 95% CI [1.15–1.49]), previous stroke or TIA (RR 1.85, 95% CI [1.32–2.60]), VKA-naïve status (RR 1.18, 95% CI [1.03–1.35]), moderate renal failure (RR 1.54, 95% CI [1.30–1.81]), severe renal failure (RR 2.22, 95% CI [1.85–2.66]), previous aspirin use (RR 1.19, 95% CI [1.04–1.37]), Asian race (RR 1.70, 95% CI [1.42–2.03]) and CHADS2 score ≥3 (RR 1.64, 95% CI [1.18–2.27]) associated with higher stroke rates |
| Pancholy et al.[37] | 2014 | Meta-analysis of 6 RCTs | NA | 26,260 | NA | Female AF patients on warfarin were at significantly greater risk of stroke or systemic embolism than their male counterparts (OR 1.28, 95% CI [1.11–1.47]), although this was not observed with DOAC therapy (OR 1.15, 95% CI [0.97–1.35]) |
| Senoo et al.[34] | 2015 | Post hoc analysis of RCT | Retrospective | 4,556 | 11.6 months | Permanent AF (HR 1.66, 95% CI [1.08–2.55]), creatinine (HR 0.35, 95% CI [0.19–0.66]), prior cerebrovascular events (HR 1.97, 95% CI [1.31–2.96]) and previous coronary disease (HR 1.74, 95% CI [1.14–2.57]) were independently associated with a composite of stroke or systemic embolism and cardiovascular death |
| Paciaroni et al.[30] | 2019 | Case-control study | Prospective | 713 | NA | Off-label low dose of DOACs (OR 3.18, 95% CI [1.95–5.85]), atrial enlargement (OR 6.64, 95% CI [4.63–9.52]), hyperlipidaemia (OR 2.40, 95% CI [1.83–3.16]), CHA2DS2-VASc score (OR 1.72, 95% CI [1.58–1.88] for each 1-point increase) and non-paroxysmal AF (OR 2.22, 95% CI [1.64–3.03]) were associated with cerebrovascular ischaemic events |
| Maeda et al.[38] | 2021 | Cohort study | Retrospective | 11,848 | 3 years | Older age (HR 2.02, 95% CI [1.49–2.73] for 65–74 versus <65 years), hypertension (HR 1.41, 95% CI [1.04–1.92]) hyperlipidaemia (HR 1.46, 95% CI [1.07–1.98]) and CHA2DS2 VASc score were significantly associated with increased risk of stroke or systemic embolism |
DOAC = direct oral anticoagulant; NA = not available or not applicable; RCT = randomised control trial; RR = relative risk; TIA = transient ischaemic attack; VKA = vitamin K antagonist.