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Comment & Response
December 10, 2014

Stroke Risk Following Perioperative Atrial Fibrillation

Author Affiliations
  • 1Division of Cardiology, Duke Clinical Research Institute, Durham, North Carolina
JAMA. 2014;312(22):2410. doi:10.1001/jama.2014.14496

To the Editor Dr Gialdini and colleagues1 presented an analysis of stroke risk following perioperative AF. The authors tried to address potential confounders and acknowledged several limitations.

A key limitation is the lack of data on antithrombotic medication use. The observed difference in increased stroke risk associated with AF between noncardiac and cardiac surgery is surprising and counterintuitive. Cardiac patients are more likely to have risk factors for stroke. This is suggested by higher stroke rates following cardiac surgery in the absence of AF compared with noncardiac surgery (0.83% vs 0.36%, respectively).

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