Evaluation of Risk Factors in Elderly Patients with Cerebral Embolism Due to Nonvalvular Atrial Fibrillation

Background: Atrial fibrillation (AF) is a major risk factor for ischemic stroke. In elderly population, the incidence of cerebral embolism (CE) caused by AF tends to be increasing. In this study, we assessed the distribution and the most frequent factor in elderly patients with an embolic event due to nonvalvular AF (NVAF). Methods: Among 435 consecutive patients with cardiogenic embolus who were referred to Stroke Care Unit at our institute, 301 patients were diagnosed as CE caused by NVAF. Of the patients, 188 patients were 75 years old or more. Patients were excluded when AF episodes were not documented on electrocardiographic monitoring. The CHADS2 score was evaluated for each of the 188 patients. Results: In 75 years old or more, the CHADS2 score was 1 in 29 (15%), 2 in 62 (33%). Among patients with a CHADS2 score of 2, a combination of hypertension and age >75 years was the most frequent pattern (85%). Conclusions: The most frequent factor was hypertension in patients 75 years old or more with CE due to NVAF. The management of blood pressure is very important for preventing cerebral embolic events in elderly population with NVAF.