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[Atrial fibrillation and stroke]
E Palomeras Soler1, J Roquer González
1Servicio de Neurología, Hospital del Mar, Barcelona. neurologia2@csm.scs.es
Insights
Atrial fibrillation (AF) significantly increases stroke severity and worsens patient outcomes. Early stroke prevention strategies in AF patients are crucial for improving prognosis and reducing complications.
Area of Science:
- Neurology
- Cardiology
- Public Health
Context:
- Atrial fibrillation (AF) is a recognized risk factor for stroke.
- Evidence suggests AF may exacerbate stroke severity and impact outcomes.
Purpose:
- To investigate the clinical characteristics, radiological findings, in-hospital outcomes, and prognosis of stroke in patients with and without AF.
Summary:
- A study of 747 stroke patients revealed that 27.4% had AF. Patients with AF were older and had a higher ratio of ischemic stroke to cerebral hemorrhage.
- AF patients experienced lower functional scores (Barthel index, Canadian score), more complications, higher mortality, longer hospital stays, and reduced home discharge rates.
- Clinical data strongly suggested embolic etiology in a majority of AF stroke cases.
Impact:
- Atrial fibrillation is independently associated with increased stroke severity and poorer outcomes.
- These findings underscore the critical need for effective stroke prevention measures in individuals with AF.
Background:
Atrial fibrillation (AF) is a known risk factor for stroke. Furthermore, it has been suggested that the severity of the stroke is increased in these patients. We studied the clinical characteristics, radiologic findings, in-hospital outcome and prognosis of stroke in patients with AF.
Methods:
All patients who were admitted due to an stroke in our Hospital since March 1, 1995 from May 15, 1997 have been analysed. They were divided in two groups, according to the presence or not of AF and we analysed: vascular risk factors, clinical characteristics, radiologic findings, in-hospital outcome and Barthel index and Canadian score on admission and at discharge.
Results:
747 patients were analysed, 205 (27.4%) with AF and 542 without it. The mean age was higher in patients with AF (p < 0.001). The ischemic stroke/cerebral hemorrhage ratio was higher in patients with AF than in those without it (OR: 3.91). We found in 3/4 of patients with AF, clinical data supporting the embolic etiology. In the AF group, Barthel index on admission and at discharge and Canadian score on admission were significantly lower. Patients with AF had more complications, a higher mortality rate, longer hospital stays and lower discharge rate to their own home.
Conclusions:
AF is independently related with a greater severity and worse outcome in patients suffering acute stroke. These findings emphasize the importance of stroke prevention in patients with AF.