Key result
AF affects ~29% of ischemic stroke patients, linked to prior stroke and increased LA volume.
Why the study?
Atrial fibrillation is a common cause of ischemic stroke that can be difficult to detect due to paroxysmal and asymptomatic occurrence, yet detection is essential for anticoagulation therapy.
What is the prevalence of atrial fibrillation and its associated factors in patients with ischemic stroke?
Cohort (n=1,500)
No
What is the prevalence of atrial fibrillation and its associated factors in patients with ischemic stroke?
Nearly 30% of ischemic stroke patients have atrial fibrillation, with previous stroke and left atrial remodeling being strong predictors, highlighting the need for targeted screening.
Encourages heightened AF surveillance in stroke patients; leaves open optimal screening strategies pending randomized evaluation.
Background and aims Atrial fibrillation (AF) is a common cause of ischemic stroke and a major global health burden. AF can be difficult to detect due to its often paroxysmal and asymptomatic occurrence. However, its detection is essential due to implications for anticoagulation therapy. The aim of this study was to determine the prevalence and factors associated with AF among ischemic stroke patients. Methods In this retrospective cohort study, all ischemic stroke patients from the Radboudumc (Nijmegen, the Netherlands) from January 2019 until October 2024 were included. Subsequently, descriptive statistics, multivariable logistic regression and generative topographic mapping (GTM) were applied. Results Of 1500 patients (median age 73 years [IQR 63-80] and 44.1% female), 29.4% had AF, of which 18.7% previously known and 10.7% newly identified (Table 1). The most significant factors associated with AF were previous ischemic stroke, increased left atrial volume and increased peak E wave velocity (Figure 1). GTM showed the phenotype with older age, more severe infarcts, previous ischemic stroke, hypertension, myocardial infarction, heart valve abnormalities, heart failure, impaired kidney function, high premature ventricular complex burden and severe left atrial remodeling to be most associated with AF (Table 2). Conclusions The prevalence of AF and stroke severity among AF-patients in this study highlights the relevance of optimizing monitoring strategies. Previous ischemic stroke, high cardiac burden and left atrial remodeling signs were most strongly associated with AF. These findings suggest potential areas for target screening, however prospective studies are essential to further investigate the causal relationship. Conflict of interest All authors: nothing to disclose. Table 1 - belongs to Results Figure 1 - belongs to Conclusions Table 2 - belongs to Conclusions
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Kempen et al. (2026) conducted a cohort in Ischemic stroke (n=1,500). Among 1500 ischemic stroke patients, the prevalence of atrial fibrillation was 29.4%, with previous ischemic stroke, increased left atrial volume, and increased peak E wave velocity most associated.
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