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Correspondence
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Volume 334:1138-1139 April 25, 1996 Number 17
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Primary Prevention of Stroke

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 by Barnett, H. J.M.
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 by Bronner, L. L.
To the Editor: In their comprehensive and extensive review of the primary prevention of stroke (Nov. 23 issue),1 Bronner et al. do not mention atrial fibrillation as a risk factor for ischemic stroke. Data from the Framingham Study2 indicate that nonrheumatic atrial fibrillation is associated with a nearly fivefold increase in the risk of ischemic stroke, and the risk increases at a rate of 5 to 7 percent per year. Cerebral infarction eventually occurs in up to 35 percent of patients with atrial fibrillation.

Four prospective studies of the primary prevention of stroke in patients with nonvalvular atrial fibrillation3,4,5,6 have . . . [Full Text of this Article]

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