By Robert Preidt
New research finds that the risk of stroke is much higher in black Americans with afib than in whites with the condition.
It's known that atrial fibrillation, which is common with advancing age, raises the odds of blood clots, stroke and heart failure. While blacks have a lower risk of developing the heart rhythm disorder compared to whites, the authors of the new study said there's been little research into how race affects stroke risk tied to afib.
That's because clinical trials looking at heart medications "have enrolled very few African-American participants, which left us with little data about risks for this patient population," said study senior author Dr. Rajat Deo. He's associate professor of cardiovascular medicine at the University of Pennsylvania.
Investigating further, his team looked at UPenn data on more than 3,500 patients with afib.
The study found that of the 538 strokes experienced by patients in the study, 254 occurred before afib was even diagnosed. In many cases, a stroke was the event that actually alerted doctors to the fact that the patient had the heart irregularity.
However, compared to whites with afib, blacks with the condition had a higher risk of stroke -- both before and after their afib diagnosis, Deo's team said.
As such, certain blood-thinning medications could help reduce this risk of stroke, especially if afib is diagnosed early on, the researchers said.
Two heart specialists who weren't involved in the new research agreed more must be done.
The study "highlights a need for greater screening in this higher risk population" of black Americans and is "a call for more research to better understand what can be done to lower their risk of stroke," said Dr. Yasir El-Sherif. He directs stroke care at Staten Island University Hospital in New York City.
Dr. Laurence Epstein directs cardiac electrophysiology at Northwell Health in Manhasset, N.Y. He said the study highlights the need for better detection and care of afib, whatever a person's race.
The new study "demonstrated that patients at risk suffered strokes even before the diagnosis of atrial fibrillation," Epstein noted, and "this was particularly true for African-Americans."
The bottom line, he said, is that "we should be more aggressively screening for atrial fibrillation in at-risk patients, and ensuring the appropriate use of blood thinners."
In a university news release, Deo noted that "evolving mobile and wearable technologies are providing individuals the opportunity to acquire cardiac rhythm data." This "real-time" monitoring of people's everyday heart rhythms should be made available to "diverse populations" to help improve afib detection and care for all Americans, he said.
The study was published Feb. 20 in the journal Heart Rhythm.