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Published on: February 26, 2013
Patterns of atrial fibrillation, relevant cardiac structural and functional changes predict functional and cognitive
Jiahuan Guo1, Dandan Wang1, Jiaokun Jia1
1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Insights
Atrial fibrillation patterns and cardiac markers predict poor functional and cognitive outcomes in stroke patients. Enhanced cardiac assessment post-stroke is recommended for better patient management.
Area of Science:
- Cardiology
- Neurology
- Medical Research
Background:
- Atrial fibrillation (AF) patterns and cardiac changes are known outcome predictors in AF.
- Their specific impact on ischemic stroke patients with AF was previously unclear.
Purpose of the Study:
- To investigate the influence of AF patterns and cardiac markers on long-term functional and cognitive outcomes in ischemic stroke patients with AF.
Main Methods:
- Retrospective cohort study of ischemic stroke patients with AF.
- AF patterns classified as AF diagnosed after stroke (AFDAS) vs. known before stroke (KAF).
- Cardiac markers (LA diameter, LVEF, BNP, cTnI) dichotomized; logistic regression used for analysis.
Main Results:
- Non-paroxysmal AF correlated with higher risks of poor functional outcome and cognitive impairment.
- Lower LVEF and higher BNP levels predicted poor functional outcomes.
- Lower LVEF, larger LA diameter, and higher BNP levels were associated with cognitive impairment.
Conclusions:
- Atrial fibrillation type and cardiac markers are significant predictors of functional and cognitive outcomes post-stroke.
- Comprehensive cardiac assessment and monitoring are crucial for stroke patients with AF.
Background:
Atrial fibrillation (AF) pattern, relevant cardiac changes are important predictors of outcomes in AF, but their impact on patients with ischemic stroke and AF remained unclear. We aimed to explore the impact of AF patterns, cardiac structural and functional markers on long-term functional and cognitive outcomes in ischemic stroke patients with AF.
Methods:
Ischemic stroke patients diagnosed with AF were enrolled in this retrospective cohort study. AF pattern was defined by both traditional and novel classification, in which patients were divided into AF diagnosed after stroke (AFDAS) and known before stroke (KAF). Left atrial (LA) diameter, left ventricular ejection fraction (LVEF), natriuretic peptide (BNP) and cardiac troponin (cTnI) were dichotomized according to the median value. Outcomes include poor functional outcome and cognitive impairment at the 1-year follow-up. Multivariable logistic regression was performed to validate the association between AF pattern, parameters of cardiac change and functional and cognitive outcome.
Results:
A total of 377 patients were included. Non-paroxysmal AF patients had a higher risk of poor functional outcome (OR = 3.59, P < 0.0001) and cognitive impairment (OR = 2.38, P = 0.019) than paroxysmal AF patients, while there were no differences between AFDAS and KAF. Lower LVEF (OR = 1.83, P = 0.045) and higher BNP (OR = 2.66, P = 0.001) were associated with poor functional outcome. Lower LVEF (OR = 2.86, P = 0.004), higher LA diameter (OR = 2.72, P = 0.008) and BNP (OR = 2.31, P = 0.023) were associated with cognitive impairment.
Conclusions:
AF type and related cardiac markers can serve as predictors for poor functional and cognitive outcomes. Comprehensive cardiac assessment and monitoring should be strengthened after stroke.
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