Study: Atrial Fibrillation Is Common But Often Undertreated in TIA Patients

Atrial fibrillation (AF) is common not only in ischemic stroke (IS) patients, but among those who have experienced transient ischemic attack (TIA), according to Lund University researchers, who note that many patients in both of these groups go undertreated.

Compared with IS, the link between AF and TIA is less well-established, according to the authors, who sought to assess the proportion of AF in patients with TIA, as well as these patients' characteristics and secondary preventive treatment, compared with patients with IS.
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The investigators analyzed hospital-based data on TIA and IS events, registered from July 2011 to June 2013, which were obtained from the Swedish Stroke Register (Riksstroke). The authors applied a time-based TIA definition (duration of symptoms <24 h), and AF was registered as present when it was known previously or was diagnosed at the time of assessment.

Overall, AF was present in 2779 of 14,980 patients with TIA, and in 13,258 of the 44,173 patients with IS. The authors also found that the proportion of AF increased with age, reaching 32.9% in TIA and 46.6% in IS patients 85 years and older.

Age, hypertension, a history of IS, and TIA, and being a nonsmoker were associated with the presence of AF in patients with AF and patients with IS. In contrast to IS, AF was less common in women than in men with TIA. At discharge, 64.2% of TIA and 50% of IS patients with AF were treated with oral anticoagulants. Proportions of AF patients treated with oral anticoagulants decreased substantially with increasing age.

Ultimately, "AF is highly prevalent not only in IS [patients], but also in TIA patients, with proportions steeply increasing with age," the researchers concluded. "In both TIA and IS, a substantial proportion of patients with AF were discharged without anticoagulant therapy."

—Mark McGraw

Reference:
Buchwald F, Norrving B, Petersson J. Atrial fibrillation in transient ischemic attack versus ischemic stroke: a Swedish Stroke Register study. [Published online August 25, 2016]. Stroke. doi:10.1161/STROKEAHA.116.013988.