{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T02:27:31Z","timestamp":1791426451948,"version":"4.3.3"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>\n              Although older age is one of the most important risk factor for stroke in atrial fibrillation (AF), the appropriate age threshold (eg, CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              -VASc score [congestive heart failure, hypertension, age \u226575 years (doubled), diabetes mellitus, prior stroke or transient ischemic attack (doubled), vascular disease, age 65\u201374 years, female], 1 point for age 65\u201374 years, 2 points for age \u226575 years) for increased risk is controversial because actual age thresholds may differ between countries and ethnic groups. We investigated the age threshold for ischemic stroke risk among Asian AF patients.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>\n              Using National Health Insurance Service database, including 426\u2009650 oral anticoagulant\u2013naive nonvalvular AF patients from 2005 to 2015, with \u22642 nongender-related CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              -VASc risk scores (CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              -VASc score 0\u20132 in males, 1\u20133 in females), we assessed the risk of ischemic stroke in AF patients according to the age.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>Patients who fulfill the age risk criterion (age, 65\u201374 years) without other risk factors showed a significantly higher risk of stroke (4.76 per 100 person-years [100PY]; adjusted hazard ratio, 2.25; 95% confidence interval [CI], 2.17\u20132.36) compared with patients with 1 risk score other than age (1.87\/100PY). Patients aged 55 to 59 years with no risk factors showed similar risk of stroke (1.94\/100PY; adjusted hazard ratio, 0.95; 95% confidence interval, 0.90\u20131.00) than patients with 1 risk score (2.06\/100PY). Patients aged 65 to 69 years and no other risk factors had similar stroke risk (4.08\/100PY; adjusted hazard ratio, 0.93; 95% confidence interval, 0.90\u20130.97) than patients with 2 nongender-related risk scores (4.42\/100PY).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>\n              Older age is the most important predictor of ischemic stroke in AF, particularly for patients with low to intermediate risk of stroke. These nationwide data suggest lowering the current age threshold (age, \u226565 years) in the CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              -VASc score to age \u226555 years might be appropriate among Asian patients with AF.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.118.021047","type":"journal-article","created":{"date-parts":[[2018,7,16]],"date-time":"2018-07-16T09:05:23Z","timestamp":1531731923000},"page":"1872-1879","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":50,"title":["Age Threshold for Ischemic Stroke Risk in Atrial Fibrillation"],"prefix":"10.1161","volume":"49","author":[{"given":"Tae-Hoon","family":"Kim","sequence":"first","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (T.-H.K., H.T.Y., E.J., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pil-Sung","family":"Yang","sequence":"additional","affiliation":[{"name":"CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea (P.-S.Y.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hee Tae","family":"Yu","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (T.-H.K., H.T.Y., E.J., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunsun","family":"Jang","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (T.-H.K., H.T.Y., E.J., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Sun","family":"Uhm","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (T.-H.K., H.T.Y., E.J., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong-Youn","family":"Kim","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (T.-H.K., H.T.Y., E.J., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Nam","family":"Pak","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (T.-H.K., H.T.Y., E.J., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moon-Hyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (T.-H.K., H.T.Y., E.J., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyoung","family":"Joung","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (T.-H.K., H.T.Y., E.J., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y.H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Sciences, University of Birmingham, United Kingdom (G.Y.H.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.98.10.946"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2016.0045"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.016926"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1160\/TH16-11-0876"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1584"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euw295"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.03.022"},{"key":"e_1_3_4_9_2","unstructured":"National Institute for Health and Care Excellence. 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