CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

August 12th, 2014

Stroke Risks Associated with Atrial Fibrillation Measured

Two retrospective JAMA studies examine aspects of the thromboembolic risks that accompany atrial fibrillation.

One study measured stroke risks after perioperative AF. Researchers looked at claims data for some 1.7 million surgical patients, roughly 1.4% of whom had perioperative new-onset AF. Stroke rates by the 1-year mark were higher with perioperative AF, both after cardiac surgery (0.99% with AF vs. 0.83% without; hazard ratio, 1.3) and especially after noncardiac surgery (1.47% vs. 0.36%; HR, 2.0).

The other study, a research letter, reports a small but significant lowering of thromboembolic risk after early (within 12 hours) cardioversion without prior anticoagulation. Researchers studied outcomes in some 5100 cardioversions done within 48 hours of symptom onset. Patients undergoing the procedure within 12 hours had a lower 30-day risk for thromboembolic complications (0.3%) than those treated between 12 and 24 hours (1.1%) or between 24 and 48 hours (also 1.1%).

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