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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(05): 288-294
DOI: 10.1590/0004-282X20170039
ARTICLES

Incidence and functional outcome of atrial fibrillation and non-atrial fibrillation- related cardioembolic stroke in Joinville, Brazil: a population-based study

Incidência e desfecho funcional de AVC cardioembólico com e sem fibrilação atrial em Joinville, Brazil: estudo de base populacional
Claudio Henrique do Amaral
1   Universidade da Região de Joinville, Joinville SC, Brasil;
2   Registro de AVC de Joinville, Joinville SC, Brasil;
,
Augusto R. Amaral
1   Universidade da Região de Joinville, Joinville SC, Brasil;
,
Vivian Nagel
2   Registro de AVC de Joinville, Joinville SC, Brasil;
,
Vanessa Venancio
2   Registro de AVC de Joinville, Joinville SC, Brasil;
,
Adriana Coronetti Garcia
2   Registro de AVC de Joinville, Joinville SC, Brasil;
,
Pedro SC Magalhaes
2   Registro de AVC de Joinville, Joinville SC, Brasil;
3   Clinica Neurologica de Joinville, Joinville SC, Brasil;
,
Alexandre L Longo
3   Clinica Neurologica de Joinville, Joinville SC, Brasil;
,
Carla HC Moro
3   Clinica Neurologica de Joinville, Joinville SC, Brasil;
,
Felipe I Reis
2   Registro de AVC de Joinville, Joinville SC, Brasil;
,
Andre D’Avila
4   Hospital SOS Cardio, Florianópolis SC, BRasil.
,
Norberto L Cabral
1   Universidade da Região de Joinville, Joinville SC, Brasil;
2   Registro de AVC de Joinville, Joinville SC, Brasil;
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ABSTRACT

Among ischemic strokes, cardioembolic (CE) stroke has the worst outcome. We measured the incidence of atrial fibrillation (AF) and non-AF related CE strokes, previous anticoagulant use, and the 90-day functional outcome. Using multiple overlapping sources, we included all CE strokes that occurred in 2015 in Joinville, Brazil. Of the 374 ischemic strokes, 23% (84) were CE. The CE age-adjusted incidence, per 1,000 person-years, was 0.14 (0.11–0.17). Of the 26 patients with known prior AF, 73% (19) were not anticoagulated, 77% (20) had a CHA2DS2VASc score ≥ 3 and 81% (21) had a HAS-BLED score < 3. After three months, approximately one third of those 26 patients died or became disabled. The incidence of CE stroke in our sample was lower than in other population-based studies. The opportunity for anticoagulation was missed in one third of cases.

RESUMO

Entre todos os subtipos de AVC isquêmico, os eventos cardioembólicos (CE) apresentam os piores prognósticos. Determinamos a incidência de AVC isquêmico CE, associada ou não à fibrilação atrial (FA), o uso prévio de anticoagulantes e os desfechos funcionais em Joinville, Brasil. Utilizando múltiplas e sobrepostas fontes de informação, registramos todos os primeiros eventos CE ocorridos em 2015. Entre 374 eventos isquêmicos, 23% (84) foram CE. A incidência ajustada, para qualquer fonte cardioembólica, foi 0.14 (0.11–0.17) por 1000 pessoas-ano. Entre 26 pacientes com FA previamente conhecida, 73% (19) não estavam anticoagulados, 77% (20) tinham ≥ 3 pontos na escala CHA2DS2VASc e 81 % (21) < 3 pontos na escala HAS-BLED. Após 3 meses, um terço destes 26 pacientes morreram ou ficaram dependentes. A incidência de AVC I CE em Joinville é menor do que em outros estudos de base populacional. Um terço dos casos de AVC I CE com FA previamente conhecida perderam a oportunidade de anticoagulação.

stroke - incidence - prognosis - population studies in public health
acidente cerebral vascular - incidência - prognóstico - estudos populacionais em saúde pública


Publication History

Received: 16 June 2016

Accepted: 03 February 2017

Article published online:
05 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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