It was unclear whether stroke symptoms that did not require a diagnosis were a marker of mild cardioembolic events. For a study, the researchers sought to determine any links between atrial fibrillation (AF) and stroke symptoms in persons who had never had a stroke or a transient ischemic attack (TIA). Researchers looked at the relationship between AF and self-reported stroke symptoms in the nationwide, prospective REGARDS (Reasons for Geographic and Racial Differences in Stroke) cohort. Over an 8-year period of follow-up, researchers conducted cross-sectional (n=27,135) and longitudinal (n=21,932) analyses of REGARDS participants without stroke or transient ischemic attack, stratified by anticoagulant or antiplatelet drug usage. The average age of the participants was 64.4 (SD±9.4) years, with 55.3% of women and 40.8% of Black participants; 28.6% of the ones with AF had stroke symptoms. The risk of stroke symptoms was higher in adults with AF taking neither anticoagulants nor antiplatelet agents (OR, 2.22; 95% CI, 1.89–2.59) or antiplatelet agents only (OR, 1.92; 95% CI, 1.61–2.29), but not in adults with AF taking anticoagulants (OR, 1.08; 95% CI, 0.71–1.65), according to the cross-sectional analysis. Adults with AF taking neither anticoagulants nor antiplatelet agents (hazard ratio [HR], 1.41; 95% CI, 1.21–1.66) or antiplatelet agents only (HR, 1.23; 95% CI, 1.04–1.46) had a higher risk of stroke symptoms than adults with AF taking anticoagulants (HR, 0.86; 95% CI, 0.62–1.18). In the absence of a stroke diagnosis, stroke symptoms might have been due to subclinical cardioembolic events or “whispering strokes.” Future research into the value of stroke symptom screening might have been necessary.
Link:www.ahajournals.org/doi/10.1161/JAHA.121.022921
