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Published on: February 26, 2013
Atrial fibrillation risk factors in patients with ischemic stroke
Paweł Wańkowicz1, Przemysław Nowacki1, Monika Gołąb-Janowska1
1Department of Neurology, Pomeranian Medical University, Szczecin, Poland.
Insights
Patients with ischemic stroke (IS) and undiagnosed atrial fibrillation (AF) are more likely to smoke, have hypertension, or a history of stroke. These findings highlight the need for vigilant monitoring of IS patients for potential AF development.
Area of Science:
- Cardiology
- Neurology
- Epidemiology
Background:
- Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia and a significant risk factor for ischemic stroke (IS).
- Classical risk factors for both AF and IS include advanced age, hypertension, diabetes mellitus, coronary heart disease, and lipid disorders.
- Understanding the specific risk factors for AF in IS patients is crucial for prevention and management.
Purpose of the Study:
- To investigate the risk factors associated with the presence of nonvalvular atrial fibrillation (NVAF) in patients who have experienced an acute ischemic stroke.
- To identify demographic and clinical characteristics that differentiate IS patients with and without AF.
Main Methods:
- A single-center retrospective study was conducted.
- The study included 696 patients with acute ischemic stroke and nonvalvular atrial fibrillation.
- A comparison group of 1678 patients with acute ischemic stroke but without atrial fibrillation was also analyzed.
Main Results:
- Patients with IS and NVAF showed a significantly higher proportion of cigarette smokers (OR = 15.742, p < 0.01), hypertension (OR = 5.161, p < 0.01), and a history of previous stroke (OR = 3.951, p < 0.01).
- Other significant risk factors identified in the IS with NVAF group included dyslipidemia (OR = 2.312, p < 0.01), coronary heart disease (OR = 2.306, p < 0.01), female gender (OR = 1.717, p < 0.01), and older age (OR = 1.084, p < 0.01).
- Diabetes mellitus showed a trend towards higher incidence in the IS with NVAF group (OR = 1.341, p < 0.01).
Conclusions:
- The study underscores the importance of comprehensive monitoring for undiagnosed AF in post-ischemic stroke patients, particularly those with identified risk factors.
- These risk factors, common to both stroke and AF, may predispose individuals to developing atrial fibrillation.
- Systematic screening and risk factor management are essential for preventing AF-related complications in stroke survivors.
Introduction:
Atrial fibrillation (AF) is the most common heart arrhythmia. The condition is known to increase the risk of ischemic stroke (IS). Classical risk factors for the development of AF include advanced age, hypertension, diabetes mellitus, coronary heart disease and lipid metabolism disorders. Importantly, these are also recognized risk factors for ischemic stroke. Therefore, the purpose of this study was to investigate AF risk factors in patients with IS.
Material And Methods:
This is single-centre retrospective study which included 696 patients with acute ischemic stroke and nonvalvular atrial fibrillation and 1678 patients with acute ischemic stroke without atrial fibrillation.
Results:
In this study we found - based on a univariable and multivariable logistic regression model - that compared to the patients with IS without AF, the group of patients which suffered from IS with nonvalvular atrial fibrillation (NVAF) had a higher proportion of patients who smoked cigarettes (OR = 15.742, p < 0.01; OR = 41.1, p < 0.01), had hypertension (OR = 5.161, p < 0.01; OR = 5.666, p < 0.01), history of previous stroke (OR = 3.951, p < 0.01; OR = 4.792, p < 0.01), dyslipidemia (OR = 2.312, p < 0.01; OR = 1.592, p < 0.01), coronary heart disease (OR = 2.306, p < 0.01; OR = 1.988, p < 0.01), a greater proportion of female patients (OR = 1.717, p < 0.01; OR = 2.095, p < 0.01), higher incidence of diabetes mellitus (OR = 1.341, p < 0.01; OR = 1.261, p = 0.106) and more patients in old age (OR = 1.084, p < 0.01; OR = 1.101, p < 0.01).
Conclusions:
Our study demonstrates a need for thorough and systematic monitoring of post-ischemic stroke patients in whom AF has not been detected and who display other important risk factors. Regardless of the stroke, these factors may be responsible for development of AF.
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