Gender differences in knowledge of stroke in patients with atrial fibrillation

A limiting factor for immediate initiation of stroke therapy is delayed hospital arrival. We assessed general knowledge on and behavior during an acute stroke with particular emphasis on prehospital temporal delays and a focus on the high-risk group of patients with atrial fibrillation (AF).

As part of the Berlin Acute Stroke Study (BASS), we interviewed patients admitted to hospital with symptoms of stroke using a standardized questionnaire. Cardiac rhythm was assessed by ECG and Holter monitor. Data analysis included additional stratification for age and gender.

Of a total of 558 patients (66.8 +/- 13.5 years; 45% female) diagnosed with TIA or stroke 28% interpreted their own symptoms correctly as due to stroke. Female patients reporting cardiac arrhythmias and having AF more often correctly interpreted their symptoms as stroke (P = 0.03), considered their symptoms urgent (P = 0.02), considered stroke a medical emergency (P < 0.05) and had shorter prehospital delay times (P = 0.001) compared to female patients not reporting cardiac arrhythmias. Male, younger (< 65 years) and older patient groups showed no such effect, respectively.

Females who know to have AF demonstrate better knowledge of stroke symptoms compared to females unaware or without this risk factor. This better knowledge translates into more appropriate behavior during an acute stroke.