Contemporary outcomes of acute ischemic stroke in atrial fibrillation patients on anticoagulation

Area of Science:

• Cardiology
• Neurology
• Public Health

Background:

• Long-term anticoagulation (AC) therapy is crucial for reducing stroke risk in patients with Atrial Fibrillation (AF).
• Limited data exists on the specific impact of AC on in-hospital stroke outcomes for AF patients.

Purpose of the Study:

• To investigate the association between pre-stroke long-term AC use and in-hospital outcomes in patients with Atrial Fibrillation (AF) and ischemic stroke.

Main Methods:

• Utilized the National Inpatient Sample (NIS) database from 2016-2020.
• Identified adult inpatients with AF and primary ischemic stroke diagnosis.
• Employed multivariate regression to analyze in-hospital outcomes, adjusting for comorbidities, comparing AC users and non-users.

Main Results:

• Included 655,540 hospitalizations; 29.7% were on long-term AC.
• AC use was linked to significantly decreased in-hospital mortality (aOR 0.62).
• AC patients showed reduced stroke severity (NIHSS 8 vs. 10) and fewer complications, including intracranial hemorrhage and GI bleeding.

Conclusions:

• Pre-stroke AC use in AF patients with ischemic stroke is associated with improved in-hospital outcomes.
• AC therapy correlates with lower mortality, reduced stroke severity, and fewer complications.
• Findings suggest the benefit of maintaining AC in AF patients at risk for stroke.