Characteristics and outcomes of atrial fibrillation detected before and after acute ischemic stroke
File(s)
Published version
Author(s)
D'Anna, Lucio
Romoli, Michele
Harvey, Kirsten
Korompoki, Eleni
Veltkamp, Roland
Type
Journal Article
Abstract
Background
Atrial fibrillation (AF) can be known before the stroke (KAF) or be newly detected after stroke (AFDAS). It is unknown whether the outcome of stroke differs between KAF and AFDAS. We performed a propensity-matched analysis to investigate the outcome of patients with AFDAS and their counterparts with KAF.
Methods
We analysed a consecutive series of patients enrolled into the EIDASAF study, a single centre, retrospective study of ischemic stroke patients with a diagnosis of AF before or after the event who had been admitted to the Hyperacute Stroke Unit of Imperial College Healthcare NHS Trust between 2010 and 2017.
Results
Overall, our cohort included 959 patients with AF and acute ischemic stroke. After propensity score matching, 547 patients were matched (404 KAF group and 143 AFDAS group). The rates of in hospital death and of haemorrhagic transformation were significantly higher in KAF patients compared to AFDAS patients. Logistic regression analysis did not reveal a statistically significant influence of AF subtypes on the outcome of death. However, in logistic regression analysis KAF was associated with increased probability of haemorrhagic transformation (OR 9.64; CI 1.29–71.68, p = 0.022) after the index event.
Conclusion
KAF is associated with an increased risk of haemorrhagic transformation but not of death when compared to AFDAS.
Atrial fibrillation (AF) can be known before the stroke (KAF) or be newly detected after stroke (AFDAS). It is unknown whether the outcome of stroke differs between KAF and AFDAS. We performed a propensity-matched analysis to investigate the outcome of patients with AFDAS and their counterparts with KAF.
Methods
We analysed a consecutive series of patients enrolled into the EIDASAF study, a single centre, retrospective study of ischemic stroke patients with a diagnosis of AF before or after the event who had been admitted to the Hyperacute Stroke Unit of Imperial College Healthcare NHS Trust between 2010 and 2017.
Results
Overall, our cohort included 959 patients with AF and acute ischemic stroke. After propensity score matching, 547 patients were matched (404 KAF group and 143 AFDAS group). The rates of in hospital death and of haemorrhagic transformation were significantly higher in KAF patients compared to AFDAS patients. Logistic regression analysis did not reveal a statistically significant influence of AF subtypes on the outcome of death. However, in logistic regression analysis KAF was associated with increased probability of haemorrhagic transformation (OR 9.64; CI 1.29–71.68, p = 0.022) after the index event.
Conclusion
KAF is associated with an increased risk of haemorrhagic transformation but not of death when compared to AFDAS.
Date Issued
2024-10-01
Date Acceptance
2024-08-27
Citation
Journal of Neurology, 2024, 271 (10), pp.6856-6865
ISSN
0340-5354
Publisher
Springer
Start Page
6856
End Page
6865
Journal / Book Title
Journal of Neurology
Volume
271
Issue
10
Copyright Statement
© The Author(s) 2024 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/39215831
PII: 10.1007/s00415-024-12671-z
Subjects
AFDAS
Atrial fibrillation
ATTACK
Clinical Neurology
Ischemic stroke
KAF
Life Sciences & Biomedicine
Neurosciences & Neurology
Science & Technology
Publication Status
Published
Coverage Spatial
Germany
Date Publish Online
2024-08-31