ArticleJournal of the American Heart Association2025
Heart Failure and Stroke Risk in Atrial Fibrillation: Temporal Trends From a Nationwide Cohort Study.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Component-level associations of anemia and renal dysfunction with competing first events in acute heart failure with atrial fibrillation.Heart and vessels · 2026Article
- NovelBiomedicines · 2026Article
- Gout and Risk of Ischemic Stroke in Patients With Atrial Fibrillation: A Nationwide Cohort Study.Stroke · 2026Observational
- Rare TruncatingGenes · 2026Article
- Age-Dependent Association between Heart Failure and Stroke Risk in Atrial Fibrillation: A Nationwide Cohort Study.Journal of the American Heart Association · 2026Article
- Primary and Secondary Prevention of Ischemic Stroke in Elderly Patients with Cardiovascular Disease: The Role of Frailty and Care Pathways.Neurology international · 2026Review
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHeart failure (HF) is a well-recognized risk factor for ischemic stroke (IS) in patients with atrial fibrillation (AF). Advancements in medical research have significantly improved the detection and management of both AF and HF. However, limited data are available on whether these changes have modified the stroke risk associated with HF in patients with AF. This nationwide retrospective cohort study aims to evaluate temporal trends in HF-related IS risk among patients with AF.
methodsThe FinACAF (Finnish AntiCoagulation in Atrial Fibrillation) registry-linkage study includes all patients in Finland with incident AF from 2007 to 2018.
resultsWe identified 229 565 patients with incident AF of whom 17.4% had HF at the time of AF diagnosis. Crude IS rates decreased both in patients with and without HF over the study period. HF was independently associated with a 30% to 50% higher IS rate in 2007 to 2010, but this association attenuated to only 10% to 15% higher in 2015 to 2018. This reduction in HF-related stroke risk was observed primarily in patients without a history of myocardial infarction (MI) (incident rate ratio in 2015-2018, 1.08 [95% CI, 0.95-1.22]), while stroke risk associated with HF remained unchanged in patients with prior MI (incident rate ratio during the entire study period, 1.23 [95% CI, 1.07-1.41]).
conclusionsStroke risk associated with HF has decreased among patients with AF, driven by a decline in HF-related stroke risk in patients without a history of MI. However, HF remains an important stroke risk factor in patients with AF with a history of MI.
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