Alcohol-Related Hospitalization Doubles Stroke Risk in AF Patients

Alcohol-related hospitalization is associated with an increased risk of ischemic stroke in patients with nonvalvular atrial fibrillation (AF), according to the results of a Swedish study.

The results were presented at the European Society of Cardiology Congress 2016 on August 27, 2016.
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AF is known to be associated with an increased risk of ischemic stroke, heart failure, and mortality. Anticoagulant treatment can reduce the risk of stroke and is prescribed based on stroke risk score. While oral anticoagulants are not indicated for low-scoring patients with AF, “low-risk” patients do still present with ischemic stroke in clinical practice.

To fully understand the incidence and predictors of ischemic stroke in this low-risk population, the researchers analyzed data from 25,252 patients with nonvalvular AF aged 18 to 64 years who were identified from the Swedish patient registry from January 1, 2006, to December 31, 2012.

The researchers collected current medication information from the National Drug Register in Sweden.

After a median follow-up of 5 years, ischemic stroke occurred at an annual rate of 3.4 per 1000 patient-years. Mortality was 7.5 per 1000 patient-years in patients without ischemic stroke and 29.6 per 1000 patient-years in those who had had an ischemic stroke during follow-up.

After further analysis, the only factors that remained significantly associated with increased ischemic stroke risk were age and alcohol-related hospitalization.

“Doctors should ask their AF patients about alcohol use and advise patients to cut down if they are drinking more than is recommended,” the researchers concluded. “The beneficial link between oral anticoagulant use and ischemic stroke in this low risk population without a recognized indication for these drugs needs further investigation, including the benefit to harm (bleeding) ratio."

—Amanda Balbi

Reference:

Al-Khalili F, Benson L, Friberg L. Alcohol abuse is associated with increased risk of ischemic stroke in low risk patients with non-valvular atrial fibrillation. Poster presented at: The European Society of Cardiology (ESC) Congress 2016; August 27, 2016; Rome, Italy. Abstract P4099.