Circulation Reports
Online ISSN : 2434-0790
Brief Reports
Triphasic Changes in Ischemic Stroke Incidence With Age in Non-Valvular Atrial Fibrillation Patients ― Pooled Analysis of the Shinken Database, J-RHYTHM Registry, and Fushimi AF Registry ―
Shinya Suzuki Takeshi YamashitaKen OkumuraHirotsugu AtarashiMasaharu AkaoHiroshi Inoue
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Supplementary material

2025 Volume 7 Issue 4 Pages 303-307

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Abstract

Background: The basis for the specific age threshold for increasing of ischemic stroke in non-valvular atrial fibrillation (NVAF) patients has not been fully evaluated.

Methods and Results: We conducted a pooled analysis of 3,588 Japanese NVAF patients without anticoagulation therapy from the Shinken Database (n=1,099), the J-RHYTHM Registry (n=1,002), and the Fushimi AF Registry (n=1,487) to determine the incidence of ischemic stroke by age group; patients aged between 31 and 90 years (n=3,455) were analyzed. During a follow-up period of 1.47 years, 69 ischemic strokes occurred (1.33% per year). The incidence of ischemic stroke exhibited triphasic changes as follows: first, it ranged from 0.00% per year to 0.41% per year across the age groups between 31–35 and 46–50 years. Second, it then rose to 1.58% per year in the 56–60-years age group, remaining around 1% per year across the age groups between 56–60 and 71–75 years, with rates ranging from 0.83% to 1.58% per year. Last, it further increased to 2.35% per year in the 76–80-year age group, remaining around 2.5% per year across the age groups between 76–80 and 86–90 years.

Conclusions: The incidence of ischemic stroke in NVAF patients exhibits triphasic changes with age, with notable increases observed in patients aged in their late 50s and late 70s.

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© 2025, THE JAPANESE CIRCULATION SOCIETY

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