Key result
AF linked to ~77% higher in-hospital mortality in acute ischemic stroke patients receiving IV t-PA.
Why the study?
Previous studies reported conflicting results regarding the prognosis of patients with acute ischemic stroke complicated by AF after thrombolysis.
Is a history of atrial fibrillation associated with increased in-hospital mortality and cerebral hemorrhage in acute ischemic stroke patients receiving IV t-PA?
Cohort
Yes
Is a history of atrial fibrillation associated with increased in-hospital mortality and cerebral hemorrhage in acute ischemic stroke patients receiving IV t-PA?
Effect estimate: adjusted OR 1.77 (95% CI 1.41-2.23)
Absolute Event Rate: 3.1% vs 0.8%
In Chinese patients with acute ischemic stroke receiving IV t-PA, a history of atrial fibrillation is associated with significantly higher in-hospital mortality and cerebral hemorrhage.
Background and purpose: Regarding the prognosis of patients with acute ischemic stroke (AIS) complicated by atrial fibrillation (AF) after thrombolysis, previous studies have reported conflicting results. This research investigates the connection between AF and in-hospital mortality following intravenous thrombolysis (IVT) in individuals with AIS. Methods: Patient data were obtained from the Chinese Stroke Center Alliance (CSCA). This study constitutes a multicenter, retrospective cohort analysis, focusing on patients who received IVT using t-PA following an AIS. The primary outcome is adverse functional outcomes, characterized by in-hospital mortality. Safety outcomes mainly include cerebral hemorrhage. Univariate and multivariate logistic regression analyses were used to evaluate the relationship between AF and IVT outcomes. Results: < 0.001). Regarding safety results, patients suffering from AF had higher in-hospital mortality (3.1% vs. 0.8%; adjusted OR 1.77, 95% CI 1.41-2.23). Conclusion: The study highlights that having a past of AF is linked to a higher chance of cerebral hemorrhage and in-hospital mortality in Chinese AIS patients following IVT. AF history is a strong predictor of in-hospital mortality (AUC = 0.85).
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Xie et al. (2026) conducted a cohort in Acute ischemic stroke (AIS). Atrial fibrillation (exposure) vs. No atrial fibrillation was evaluated on In-hospital mortality (adjusted OR 1.77, 95% CI 1.41-2.23). Atrial fibrillation in acute ischemic stroke patients receiving IV t-PA was associated with higher in-hospital mortality (3.1% vs. 0.8%; adjusted OR 1.77, 95% CI 1.41-2.23).
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