Atrial fibrillation in UK South Asian hospitalized ischemic stroke patients: The BRAINS study.

ABSTRACT

INTRODUCTION: South Asian diaspora comprise one of the largest ethnic minority groups in the world yet data about atrial fibrillation (AF) in this demographic is understudied. Our aim is to identify differences in AF prevalence and treatment between South Asians and white British stroke patients. METHOD: The UK arm of a prospective ongoing large international repository on stroke was analysed. Ethnic differences in AF prevalence and management in those with ischemic stroke were analysed. RESULTS: Of the 3515 individuals recruited with ischemic stroke, 1482 (men 972, women 510) were South Asian and 2033 (men1141, women892) of white British ethnicity. AF was present in 462 white British and 193 South Asians stroke patients, with South Asians displaying a lower prevalence of AF (South Asians 13.0% vs white British 22.7%, P<0.001). Despite adjustment for traditional AF risk factors, South Asians had a significantly lower OR of AF compared to white British stroke patients (OR 0.40, 95%CI 0.330.49, P<0.001). Among confirmed AF cases, 31.8% of South Asians and 41.4% of white British were untreated at admission (P = 0.02). Antiplatelet treatment was significantly higher among South Asians at both admission (South Asian 47.4% vs. white British 29.9%, P<0.001) and discharge (South Asian 49.5% vs. white British 34.7%, P = 0.001), although anticoagulation treatment was similar across both ethnic groups at admission (South Asian 28.5% vs white British 28.1%, P = 0.93), and discharge (South Asian 45.1% vs white British 43.1%, P = 0.64). CONCLUSION: Stroke patients of South Asian descent are at significantly lower risk of AF but more likely to be on antiplatelet treatment compared to their white British counterparts.