Atrial fibrillation in patients with ischaemic stroke: clinical characteristics and in-hospital outcomes. A pilot study
Streszczenie
Introduction. Thromboembolic complications are the most severe consequences of atrial fibrillation (AF). AF is associated with significantly worse outcomes in patients with ischaemic stroke. The aim of the study was to evaluate the prevalence of AF, concomitant conditions, and in-hospital outcomes in patients hospitalized due to ischaemic stroke.
Material and methods. Our retrospective study included 2000 patients hospitalized due to ischaemic stroke in 2013–2014. The diagnosis of ischaemic stroke was based on clinical presentations and brain imaging studies (head CT or MRI).
Results. Overall, AF was present in 579 of 2000 patients (28.5%) [AF(+) group]. In 456 of these patients (78.8%), this arrhythmia was diagnosed previously, and in 123 (21.2%) patients AF was newly detected on admission. The mean patient age was 78.6 years in the AF(+) group and 71.6 years in the AF(–) group. Carotid ultrasound was performed in 1,805 patients with ischaemic stroke and showed a critical carotid artery stenosis (> 70%) in 232 patients (16.3%) in the AF(+) group and in 69 (11.9%) patients in the AF(–) group. Major neurological deficit (NIHSS score > 10) on admission was found in 485 patients (34.2%) in the AF(–) group and in 196 patients (33.85%) in the AF(+) group. At discharge, persistence of a major neurological deficit or worsening of the functional status was noted in 224 patients (15.7%) without AF and in 226 (39.03%) patients with AF. Two hundred twenty-nine patients (16.1%) without AF and 90 patients (15.5%) with AF died during hospitalization.
Conclusions. Atrial fibrillation was common arrhythmia in patients with ischaemic stroke. Patients with stroke and AF were older than patients with stroke and sinus rhythm. Critical carotid artery stenosis was more common in patients with AF compared to those without AF, as was worsening of the neurological deficit during hospitalization, In-hospital mortality was similar in stroke patients with AF or sinus rhythm.
Słowa kluczowe: ischaemic strokeatrial fibrillationthromboembolic complications
Referencje
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