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22. European Stroke Conference 12 Stroke prevention A 12:20 - 12:30 Secondary Stroke Prevention in Patients with Atrial Fibrillation in Germany – Baseline Data from the Prospective Registry of the German Competence Network on Atrial Fibril-lation K. G. Haeusler1, A. Gerth2, T. Limbourg3, G. Breithardt4, P. Kirchhof5, T. Meinertz6, M. Oeff7, U. Ravens8, U. Tebbe9, K. Wegscheider10, G. Steinbeck11, M. Naebauer12 Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, GERMANY1,- Medical Hospital I, Ludwig-Maximilians-University Munich, Munich, GERMANY2, Institut für Herzinfarktforschung, Ludwigshafen, GERMANY3, Department of Cardiology and Angi-ology, University Hospital Münster, Münster, GERMANY4, University of Birmingham, Centre for Cardiovascular Sciences, Birmingham, UNITED KINGDOM5, Department of Cardiology/ Angiology, University Hospital Eppendorf, Hamburg, GERMANY6, Department of Medicine I, Brandenburg Municipal Hospital, Brandenburg, GERMANY7, Department of Pharmacology and Toxicology, Medical Faculty, Dresden University of Technology, Dresden, GERMANY8, Department of Cardiology, Hospital Detmold, Detmold, GERMANY9, Institute for Medical Biometry and Epidemiology, University Hospital Eppendorf, Hamburg, GERMANY10, Medical Hospital I, Ludwig-Maximilians-University Munich, Munich, GER-MANY11, Medical Hospital I, Ludwig-Maximilians-University Munich, Munich, GERMANY12 Background: Anticoagulation with vitamin K antagonists (VKAs) significantly reduces the risk of recurrent stroke in stroke patients with atrial fibrillation (AF) and is strongly recommended by current guidelines. Methods: The German Competence NETwork on Atrial Fibrillation (AFNET) established a na-tionwide registry and included 9,575 patients with AF. This registry provides the opportunity to analyse clinical management of AF patients with prior stroke, treated at various levels of medi-cal care in Germany. Results: Overall, 896 (9.4%) registry patients (mean age 71.3 +/- 9.6 years; 43% female; mean CHADS2 score 3.7 +/- 1.0) reported an ischemic stroke (n=558, 5.8%), a transient ischemic at-tack (TIA, n=268, 2.8%), or both (n=70, 0.7%) before enrolment. Compared to registry patients without prior ischemic stroke, stroke patients were significantly older, more often female, had a higher rate of common cardiovascular risk factors, and received anticoagulation therapy more frequently. Overall, 71.8% of all stroke patients with known AF and without evident contraindi-cations for VKAs received anticoagulation before enrolment to the registry. After the enrolment visit, 77.4% of all AF patients with prior stroke received anticoagulation. However, univari-ate analysis revealed that known risk factors for recurrent ischemic stroke like old age, higher CHADS2 score, and chronic kidney disease were inversely associated with prescription of an-ticoagulant therapy in stroke patients before enrolment to the AFNET registry and immediately after the enrolment visit. Conclusion: Our data indicate that anticoagulation was prescribed for secondary stroke preven-tion in a relevant proportion of registry patients. Nevertheless, secondary stroke prevention was insufficiently tailored to patients’ cardiovascular risk profiles. 11 Stroke prevention A 12:10 - 12:20 POPULATION SCREENING OF 75-YEAR-OLD INDIVIDUALS FOR SILENT ATRI-AL FIBRILLATION – PRELIMINARY DATA FROM THE STROKESTOP TRIAL E. Svennberg1, J. Engdahl2, V. Frykman-Kull3, L. Friberg4, L.-Å. Levin5, M. Rosenqvist6 Danderyd’s University Hospital, Danderyd, SWEDEN1,Halland’s Hospital, Halmstad, SWE-DEN2, Danderyd’s University Hospital, Danderyd, SWEDEN3, Danderyd’s University Hospi-tal, Danderyd, SWEDEN4, Linköping University, Linköping, SWEDEN5, Danderyd’s Universi-ty Hospital, Danderyd, SWEDEN6 Background: Atrial fibrillation (AF) is a frequent source of cardiac emboli in patients with ischemic stroke. AF may be asymptomatic and therefore undiagnosed. As oral anticoagula-tion (OAC) treatment is highly effective for stroke prevention, screening for silent AF seems suitable in risk populations. Above age 75, the current guidelines recommend anticoagulation for AF, even in the absence of other risk factors. We hypothesize that AF screening in this age group will reduce stroke incidence. Methods: All inhabitants in Stockholm County and Region Halland, Sweden age 75-76 years (n=25 415) are randomized in a 1:1 fashion either to be invited to a screening program for AF or to a control group. In the screening group, participants are invited to undergo intermittent ambulatory ECG recordings during two weeks. Participants in whom AF is detected are offered OAC treatment. Screening-and control groups will be followed prospectively for 5 years with regard to thromboembolic events, bleeding and mortality. Results: During a 9 month period, 10 503 inhabitants in the screening arm had been invited and 4783 (46%) participated. Previously undiagnosed AF has been found in 131 (3%) of partic-ipants and another 85 (2%) have been identified with previously known AF but without OAC treatment. Participation in the screening program is lower in urban Stockholm (45%) in com-parison to rural Halland (64%). Conclusion: Population based AF screening in a 75-year old population identifies 5% of the population as new candidates for OAC treatment due to AF. There are considerable local and regional variations in participation in the screening program. 126 © 2013 S. Karger AG, Basel Scientific Programme


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