[Cardioembolic stroke associated with atrial fibrillation]

Area of Science:

• Neurology
• Cardiology
• Public Health

Background:

• Cardioembolic stroke accounts for 30% of brain infarctions, frequently originating from atrial fibrillation (AF).
• AF-related strokes disproportionately affect elderly women, involve major cerebral artery occlusion, and result in large infarcts, leading to severe patient outcomes and high mortality.
• Anticoagulant use prior to stroke onset is suboptimal (32%), with inadequate therapeutic anticoagulation (PT-INR < 1.6 in 58.4% of patients).

Purpose of the Study:

• To investigate the characteristics, outcomes, and management of cardioembolic stroke, particularly in patients with atrial fibrillation.
• To evaluate the incidence of intracardiac thrombus and recurrence rates in stroke patients with AF.
• To highlight the critical need for improved stroke prevention strategies in AF patients.

Main Methods:

• Retrospective analysis of stroke patient data, focusing on those with atrial fibrillation.
• Utilized transesophageal echocardiography for intracardiac thrombus detection.
• Compared mortality and recurrence rates between stroke patients with and without AF.

Main Results:

• Transesophageal echocardiography detected intracardiac thrombus in 16.4% of patients.
• Hospitalized stroke recurrence was 7.5%, not significantly higher than in non-AF stroke patients.
• Mortality rates were significantly higher in stroke patients with AF compared to those without AF within five years post-discharge.

Conclusions:

• Cardioembolic stroke due to atrial fibrillation presents a severe clinical challenge with high mortality.
• Effective anticoagulation management and timely thrombus detection are essential for mitigating adverse outcomes.
• AF-related brain infarction warrants aggressive management and recognition as a distinct, high-risk stroke subtype.