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Large Burden of Stroke Incidence in People with Cardiac Disease: A Linked Data Cohort Study.

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dc.contributor.authorRobinson, K.
dc.contributor.authorKatzenellenbogen, J.M.
dc.contributor.authorKleinig, T.J.
dc.contributor.authorKim, J.
dc.contributor.authorBudgeon, C.A.
dc.contributor.authorThrift, A.G.
dc.contributor.authorNedkoff, L.
dc.date.issued2023
dc.description.abstractPurpose: People with cardiac disease have 2–4 times greater risk of stroke than the general population. We measured stroke incidence in people with coronary heart disease (CHD), atrial fibrillation (AF) or valvular heart disease (VHD). Methods: We used a person-linked hospitalization/mortality dataset to identify all people hospitalized with CHD, AF or VHD (1985– 2017), and stratified them as pre-existing (hospitalized 1985–2012 and alive at October 31, 2012) or new (first-ever cardiac hospitalization in the five-year study period, 2012–2017). We identified first-ever strokes occurring from 2012 to 2017 in patients aged 20–94 years and calculated age-specific and age-standardized rates (ASR) for each cardiac cohort. Results: Of the 175,560 people in the cohort, most had CHD (69.9%); 16.3% had multiple cardiac conditions. From 2012–17, 5871 first-ever strokes occurred. ASRs were greater in females than males in single and multiple condition cardiac groups, largely driven by rates in females aged ≥75 years, with stroke incidence in this age group being at least 20% greater in females than males in each cardiac subgroup. In females aged 20–54 years, stroke incidence was 4.9-fold greater in those with multiple versus single cardiac conditions. This differential declined with increasing age. Non-fatal stroke incidence was greater than fatal stroke in all age groups except in the 85–94 age group. Incidence rate ratios were up to 2-fold larger in new versus pre-existing cardiac disease. Conclusion: Stroke incidence in people with cardiac disease is substantial, with older females, and younger patients with multiple cardiac conditions, at elevated risk. These patients should be specifically targeted for evidence-based management to minimize the burden of stroke.
dc.description.statementofresponsibilityKeira Robinson, Judith M Katzenellenbogen, Timothy J Kleinig, Joosup Kim, Charley A Budgeon, Amanda G Thrift, Lee Nedkoff
dc.identifier.citationClinical Epidemiology, 2023; 15:203-211
dc.identifier.doi10.2147/clep.s390146
dc.identifier.issn1179-1349
dc.identifier.issn1179-1349
dc.identifier.orcidKleinig, T.J. [0000-0003-4430-3276]
dc.identifier.urihttps://hdl.handle.net/2440/137851
dc.language.isoen
dc.publisherInforma UK Limited
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1182071
dc.rights© 2023 Robinson et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms. php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
dc.source.urihttps://doi.org/10.2147/clep.s390146
dc.subjectatrial fibrillation
dc.subjectcardiac disease
dc.subjectcoronary heart disease
dc.subjectrisk factors
dc.subjectstroke incidence
dc.subjectvalvular heart disease
dc.titleLarge Burden of Stroke Incidence in People with Cardiac Disease: A Linked Data Cohort Study.
dc.typeJournal article
pubs.publication-statusPublished

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