{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:41:38Z","timestamp":1753882898297,"version":"3.41.2"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,6,13]]},"abstract":"\n Background<\/jats:title>\n While atrial fibrillation is a recognized risk factor for stroke, contemporary data on trends in stroke incidence after the diagnosis of atrial fibrillation are scarce.<\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Olmsted County,\n MN<\/jats:styled-content>\n residents with incident atrial fibrillation or atrial flutter (collectively referred to as\n AF<\/jats:styled-content>\n ) from 2000 to 2010 were identified. Cox regression determined associations of year of\n AF<\/jats:styled-content>\n diagnosis with ischemic stroke and transient ischemic attack (\n TIA<\/jats:styled-content>\n ) occurring through 2013. Among 3247\n AF<\/jats:styled-content>\n patients, 321 (10%) had an ischemic stroke\/\n TIA<\/jats:styled-content>\n over a mean of 4.6\u00a0years (incidence rate [95%\n CI<\/jats:styled-content>\n ] per 100\u00a0person\u2010years: 2.14 [1.91\u20132.38]). Two hundred thirty\u2010nine (7%) of 3265\n AF<\/jats:styled-content>\n patients experienced an ischemic stroke (incidence rate: 1.54 [1.35\u20131.75]). The risk of both outcomes remained unchanged over time after adjusting for demographics and comorbidities (hazard ratio [95%\n CI<\/jats:styled-content>\n ] per year of\n AF<\/jats:styled-content>\n diagnosis: 1.00 [0.96\u20131.04] for ischemic stroke\/\n TIA<\/jats:styled-content>\n ; 1.01 [0.96\u20131.06] for ischemic stroke only). In analyses restricted to patients with prescription information, the rates of anticoagulation use did not change over time, reaching 50.8% at 1\u00a0year after\n AF<\/jats:styled-content>\n diagnosis. Further adjustment for anticoagulation use did not alter the temporal trends in stroke incidence (hazard ratio [95%\n CI<\/jats:styled-content>\n ] per year of\n AF<\/jats:styled-content>\n diagnosis: 1.06 [0.97\u20131.15] for ischemic stroke\/\n TIA<\/jats:styled-content>\n ; 1.08 [0.98\u20131.20] for ischemic stroke only).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Strokes\/\n TIA<\/jats:styled-content>\n s are frequent after\n AF<\/jats:styled-content>\n , occurring in 10% of patients after 5\u00a0years of follow\u2010up. The occurrence of stroke\/\n TIA<\/jats:styled-content>\n did not decline over the last decade, which may be influenced by a leveling off of anticoagulation use. This concerning trend has major public health implications.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.003408","type":"journal-article","created":{"date-parts":[[2016,6,14]],"date-time":"2016-06-14T03:00:59Z","timestamp":1465873259000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["No Decline in the Risk of Stroke Following Incident Atrial Fibrillation Since 2000 in the Community: A Concerning Trend"],"prefix":"10.1161","volume":"5","author":[{"given":"Alanna M.","family":"Chamberlain","sequence":"first","affiliation":[{"name":"Department of Health Sciences Research, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Robert D.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvaro","family":"Alonso","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard J.","family":"Gersh","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jill M.","family":"Killian","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Research, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan A.","family":"Weston","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Research, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V\u00e9ronique L.","family":"Roger","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Research, Mayo Clinic, Rochester, MN"},{"name":"Division of Cardiovascular Diseases, Mayo Clinic, Rochester, 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