Statistics

Hi.
Can anyone point me to real number statistics as to how many non afib patients per thousand die of stroke, and how many afib patients per thousand die of the same?
Then how many of the afib stroke deaths are in those not taking anticoagulants?
I am trying to assess risk, but can't find any statistics to help.
Best
John

Hi John,

I last read the European Society of Cardiology Guidelines for the diagnosis and management of atrial fibrillation a number of years ago As I recall, at least some of the stats should be in the references to this paper. The 2020 version is here: [www.escardio.org]

One way to look at it:

[www.mdcalc.com]

Calculate your CHADS2 score and see the percentage risk of a stroke without a blood thinner

Deaths due to stroke isn't the number to look at because many strokes don't result in death. The outcome can be all over the place from minor to severe, including outcomes that are far worse than death.

Thanks Folks,
I shall do some reading from your links.
Point taken Carey, so where could I find those relevent outcomes?
I have read in JAMA Cardiology a multi centre study suggesting stroke is most likely to occur within 5 days of an episode. I have also read of the intermittent use of NOAC's for only a period after an episode (2 weeks) and then ceasing same. Does anyone have experience of this regimen?
Cheers,
John

With a CHADS score of zero, the following is stated:

Low risk of thromboembolic event. 1.9% risk of event per year if no coumadin.
The adjusted stroke rate was the expected stroke rate per 100 person-years derived from the multivariable model assuming that aspirin was not taken.

Does this mean that 19 people out of 1000 afib patients might have a stroke? What is the multivariable model that produces the expected stroke rate?
I note that in the evidence section, the study providing these data was written in(2004 Gage 2004).

Quote
JohnBM
I have also read of the intermittent use of NOAC's for only a period after an episode (2 weeks) and then ceasing same. Does anyone have experience of this regimen?
Cheers,
John

I don't but am considering it. It would be better than not taking anything, I would expect.
You may have already read this article by Dr. Rod Passman.
He claims “We know that only about half the patients who should be receiving an anticoagulant are actually prescribed one and when we do prescribe it, probably only half are still taking it after a year or two,”.

[www.ahajournals.org]



Edited 1 time(s). Last edit at 07/24/2022 06:01PM by colindo.

Quote
JohnBM
I have also read of the intermittent use of NOAC's for only a period after an episode (2 weeks) and then ceasing same. Does anyone have experience of this regimen?

Yes, I did that for almost 2 years. I went through a single bottle of Eliquis in that entire time. However, I was a CHADS-Vasc zero at the time, so my EP was okay with it. Whether that's an option for you or anyone else depends on your CHADS-Vasc score. If your score is more than zero I'd say it's iffy, and if it's more than 1 I'd say forget it. Whatever it is you don't like about anticoagulants is dwarfed by what you won't like about stroke.

Not statistics but relevant. my cousin, 64 yrs old had a stroke 24hrs after her Afib episode. She was in Costco when her left side lost movement. She's a cardiac nurse, had a low Chad score was not taking a blood thinner. She is now taking Eliquis and has recovered 90%. Thankfully.

Quote
JohnBM
I have read in JAMA Cardiology a multi centre study suggesting stroke is most likely to occur within 5 days of an episode.

do you have a link or citation? thanks

Quote
JohnBM
I am trying to assess risk, but can't find any statistics to help.

“Statistical shape analysis of the left atrial appendage predicts stroke in atrial fibrillation.”

Bieging, Erik T et al.
The international journal of cardiovascular imaging
vol. 37,8 (2021): 2521-2527.
doi:10.1007/s10554-021-02262-8

[www.ncbi.nlm.nih.gov]

Conclusions We propose a quantitative, SSA approach to quantify shape of the LA and LAA, and demonstrate that shape of the LAA predicts stroke in AF patients. While statistically complex, our approach makes no assumptions about the most relevant shape to stroke and instead learns what LAA shape is associated with increased stroke risk. This improves upon stroke prediction beyond CHA2DS2-VASc score alone. This approach may lead to a more reproducible and thus more clinically useful way to use LAA shape to assess stroke risk in AF patients.



Edited 1 time(s). Last edit at 09/19/2022 09:45PM by Kwilk.