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- Publisher Website: 10.1016/j.hrthm.2008.10.023
- Scopus: eid_2-s2.0-59149092293
- PMID: 19187905
- WOS: WOS:000263147800004
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Article: Risk of ischemic stroke after new-onset atrial fibrillation in patients with hyperthyroidism
Title | Risk of ischemic stroke after new-onset atrial fibrillation in patients with hyperthyroidism |
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Authors | |
Keywords | Atrial fibrillation Hyperthyroidism Ischemic stroke |
Issue Date | 2009 |
Publisher | Elsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/heartrhythmjournal |
Citation | Heart Rhythm, 2009, v. 6 n. 2, p. 169-173 How to Cite? |
Abstract | Background: Hyperthyroidism is one of the most common reversible causes of atrial fibrillation (AF); nevertheless, the risk of ischemic stroke in patients with hyperthyroidism who present with new-onset AF is unclear. Objective: This study sought to investigate the clinical outcome of hyperthyroidism-induced AF with regard to risk of ischemic stroke risk. Methods: We prospectively studied the incidence, time course, and clinical predictors for ischemic stroke in patients with hyperthyroidism-induced AF (n = 160). They were compared with age- and sex-matched cohorts of hyperthyroid patients without AF (n = 160) and AF patients without hyperthyroidism (n = 160). Results: Baseline characteristics were comparable among the 3 groups. At 1 year, 86 hyperthyroid patients with AF (54%) and 92 patients with nonthyroid AF (58%) had spontaneous or pharmacological sinus conversion (P = .20). Ischemic stroke was observed in 15 hyperthyroid patients with AF (9.4%) versus 5 patients with nonthyroid AF (3.1%, P = .02), and 1 hyperthyroid patient without AF (0.6%, P < .001). Furthermore, the majority of ischemic stroke (>70%) in patients with AF occurred within the first 30 days of presentation, whereas AF was still present. Cox regression analysis showed that hyperthyroidism (hazard ratio [HR]: 3.5, 95% confidence interval [CI]: 1.15 to 10.42, P = .03) and persistent AF (HR: 13.0, 95% CI: 2.88 to 58.80, P < .01) predicted the occurrence of ischemic stroke; warfarin therapy reduced the risk of ischemic stroke (HR: 0.17, 95% CI: 0.04 to 0.79, P = .02). Conclusion: In hyperthyroid patients who presented with new-onset AF, there was an increased risk of ischemic stroke clustering during the initial phase of presentation. This should prompt early use of anticoagulation therapy in hyperthyroid patients with AF. © 2009 Heart Rhythm Society. |
Persistent Identifier | http://hdl.handle.net/10722/92559 |
ISSN | 2023 Impact Factor: 5.6 2023 SCImago Journal Rankings: 2.072 |
ISI Accession Number ID | |
References |
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Siu, CW | en_HK |
dc.contributor.author | Pong, V | en_HK |
dc.contributor.author | Zhang, X | en_HK |
dc.contributor.author | Chan, YH | en_HK |
dc.contributor.author | Jim, MH | en_HK |
dc.contributor.author | Liu, S | en_HK |
dc.contributor.author | Yiu, KH | en_HK |
dc.contributor.author | Kung, AWC | en_HK |
dc.contributor.author | Lau, CP | en_HK |
dc.contributor.author | Tse, HF | en_HK |
dc.date.accessioned | 2010-09-17T10:50:05Z | - |
dc.date.available | 2010-09-17T10:50:05Z | - |
dc.date.issued | 2009 | en_HK |
dc.identifier.citation | Heart Rhythm, 2009, v. 6 n. 2, p. 169-173 | en_HK |
dc.identifier.issn | 1547-5271 | en_HK |
dc.identifier.uri | http://hdl.handle.net/10722/92559 | - |
dc.description.abstract | Background: Hyperthyroidism is one of the most common reversible causes of atrial fibrillation (AF); nevertheless, the risk of ischemic stroke in patients with hyperthyroidism who present with new-onset AF is unclear. Objective: This study sought to investigate the clinical outcome of hyperthyroidism-induced AF with regard to risk of ischemic stroke risk. Methods: We prospectively studied the incidence, time course, and clinical predictors for ischemic stroke in patients with hyperthyroidism-induced AF (n = 160). They were compared with age- and sex-matched cohorts of hyperthyroid patients without AF (n = 160) and AF patients without hyperthyroidism (n = 160). Results: Baseline characteristics were comparable among the 3 groups. At 1 year, 86 hyperthyroid patients with AF (54%) and 92 patients with nonthyroid AF (58%) had spontaneous or pharmacological sinus conversion (P = .20). Ischemic stroke was observed in 15 hyperthyroid patients with AF (9.4%) versus 5 patients with nonthyroid AF (3.1%, P = .02), and 1 hyperthyroid patient without AF (0.6%, P < .001). Furthermore, the majority of ischemic stroke (>70%) in patients with AF occurred within the first 30 days of presentation, whereas AF was still present. Cox regression analysis showed that hyperthyroidism (hazard ratio [HR]: 3.5, 95% confidence interval [CI]: 1.15 to 10.42, P = .03) and persistent AF (HR: 13.0, 95% CI: 2.88 to 58.80, P < .01) predicted the occurrence of ischemic stroke; warfarin therapy reduced the risk of ischemic stroke (HR: 0.17, 95% CI: 0.04 to 0.79, P = .02). Conclusion: In hyperthyroid patients who presented with new-onset AF, there was an increased risk of ischemic stroke clustering during the initial phase of presentation. This should prompt early use of anticoagulation therapy in hyperthyroid patients with AF. © 2009 Heart Rhythm Society. | en_HK |
dc.language | eng | en_HK |
dc.publisher | Elsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/heartrhythmjournal | en_HK |
dc.relation.ispartof | Heart Rhythm | en_HK |
dc.subject | Atrial fibrillation | en_HK |
dc.subject | Hyperthyroidism | en_HK |
dc.subject | Ischemic stroke | en_HK |
dc.subject.mesh | Adult | en_HK |
dc.subject.mesh | Atrial Fibrillation - complications | en_HK |
dc.subject.mesh | Brain Ischemia - epidemiology - etiology | en_HK |
dc.subject.mesh | Case-Control Studies | en_HK |
dc.subject.mesh | Female | en_HK |
dc.subject.mesh | Humans | en_HK |
dc.subject.mesh | Hyperthyroidism - complications | en_HK |
dc.subject.mesh | Incidence | en_HK |
dc.subject.mesh | Male | en_HK |
dc.subject.mesh | Middle Aged | en_HK |
dc.subject.mesh | Proportional Hazards Models | en_HK |
dc.subject.mesh | Prospective Studies | en_HK |
dc.subject.mesh | Risk | en_HK |
dc.title | Risk of ischemic stroke after new-onset atrial fibrillation in patients with hyperthyroidism | en_HK |
dc.type | Article | en_HK |
dc.identifier.email | Siu, CW:cwdsiu@hkucc.hku.hk | en_HK |
dc.identifier.email | Chan, YH:chanwill@hku.hk | en_HK |
dc.identifier.email | Liu, S:shasha.vivi@gmail.com | en_HK |
dc.identifier.email | Yiu, KH:khkyiu@hku.hk | en_HK |
dc.identifier.email | Kung, AWC:awckung@hku.hk | en_HK |
dc.identifier.email | Tse, HF:hftse@hkucc.hku.hk | en_HK |
dc.identifier.authority | Siu, CW=rp00534 | en_HK |
dc.identifier.authority | Chan, YH=rp01313 | en_HK |
dc.identifier.authority | Liu, S=rp01628 | en_HK |
dc.identifier.authority | Yiu, KH=rp01490 | en_HK |
dc.identifier.authority | Kung, AWC=rp00368 | en_HK |
dc.identifier.authority | Tse, HF=rp00428 | en_HK |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1016/j.hrthm.2008.10.023 | en_HK |
dc.identifier.pmid | 19187905 | - |
dc.identifier.scopus | eid_2-s2.0-59149092293 | en_HK |
dc.identifier.hkuros | 153473 | - |
dc.relation.references | http://www.scopus.com/mlt/select.url?eid=2-s2.0-59149092293&selection=ref&src=s&origin=recordpage | en_HK |
dc.identifier.volume | 6 | en_HK |
dc.identifier.issue | 2 | en_HK |
dc.identifier.spage | 169 | en_HK |
dc.identifier.epage | 173 | en_HK |
dc.identifier.isi | WOS:000263147800004 | - |
dc.publisher.place | United States | en_HK |
dc.identifier.scopusauthorid | Siu, CW=7006550690 | en_HK |
dc.identifier.scopusauthorid | Pong, V=26025247300 | en_HK |
dc.identifier.scopusauthorid | Zhang, X=16425051500 | en_HK |
dc.identifier.scopusauthorid | Chan, YH=22633700600 | en_HK |
dc.identifier.scopusauthorid | Jim, MH=6603860344 | en_HK |
dc.identifier.scopusauthorid | Liu, S=16424616100 | en_HK |
dc.identifier.scopusauthorid | Yiu, KH=35172267800 | en_HK |
dc.identifier.scopusauthorid | Kung, AWC=7102322339 | en_HK |
dc.identifier.scopusauthorid | Lau, CP=35275317200 | en_HK |
dc.identifier.scopusauthorid | Tse, HF=7006070805 | en_HK |
dc.identifier.issnl | 1547-5271 | - |