Clinical and demographic features of patients with stroke and atrial fibrillation

Background. Stroke takes the second place among all causes for cardiovascular death and the first place in mortality and disability among other nervous system diseases. Atrial fibrillation (AF) is presently is a commonly recognized, independent risk factor for ischemic stroke, which fivefold increases the risk of an unfavorable outcome. Prevention of stroke is a complicated medical and social challenge. Aim. To study AF prevalence among patients with stroke/ transient ischemic attack (TIA) who had received an anticoagulant therapy before hospitalization. Materials and methods. A retrospective analysis of case reports was performed for patients diagnosed with acute cerebrovascular disease and TIA who had received a therapy from January, 2013 through December, 2015 (n=7921). From these case reports, 849 case reports of patients with concurrent AF were selected. Results. In patients with stroke/TIA, the AF incidence was 10.72%. Risk assessment using the CHA 2 DS 2 -VASc scale showed that the percentage of low-risk patients (score 0) was 0.8%, intermediate risk patients (score 1) - 5.3%, and high-risk patients (score ≥2) - 93.8%; 4.7% of patients with AF received preven tive therapy for thromboembolic complications. The death rate of patients with AF and stroke/TIA was 15.78% whereas in-hospital death rate of patients without AF was 7.01%. Therefore, AF is a statistically significant risk factor of in-hospital mortality for patients with stroke/TIA (OR=2.485, 95% CI: 2.023-3.053, p<0.001,). The following factors influenced the in-hospital mortality of patients with ischemic stroke and concurrent AF: severe CHF, type 2 diabetes mellitus, peripheral thrombosis, history of a transcutaneous coronary intervention, oncological disease, and impaired glomerular filtration rate. Conclusion. The study demonstrated an effect of AF on in-hospital mortality of patients with ischemic stroke and a low rate of preventive anticoagulant therapy in patients with AF.