Key result
Atrial fibrillation detected after stroke was not associated with a significant difference in functional independence at 90 days compared to known atrial fibrillation or no atrial fibrillation in patients undergoing mechanical thrombectomy.
Why the study?
Outcomes after mechanical thrombectomy in acute LVO ischemic stroke needed comparison between patients with AF detected after stroke and those with known AF.
Does the timing of atrial fibrillation diagnosis (detected after stroke vs known) affect functional independence at 90 days in acute stroke patients with large vessel occlusion treated with mechanical thrombectomy?
Observational (n=518)
No
Does the timing of atrial fibrillation diagnosis (detected after stroke vs known) affect functional independence at 90 days in acute stroke patients with large vessel occlusion treated with mechanical thrombectomy?
Absolute Event Rate: 66.4% vs 65.6%
p-value: p=0.311
The timing of atrial fibrillation diagnosis (detected after stroke vs known) does not significantly impact clinical and safety outcomes in acute ischemic stroke patients with large vessel occlusion undergoing mechanical thrombectomy.
AFDAS may yield distinct 90-day outcomes versus KAF after MT for LVO; leaves open whether anticoagulation should differ.
We aim to compare the outcomes in patients with atrial fibrillation detected after stroke (AFDAS) and their counterparts with known AF (KAF) presenting with large vessel occlusion (LVO) treated with mechanical thrombectomy (MT). This observational, prospective study included consecutive patients with acute LVO ischemic stroke of the anterior circulation with AFDAS, KAF and without AF. The primary study outcome was functional independence at 90 days after stroke. The secondary study outcomes were variation of the NIHSS score at 24 h, rate of successful reperfusion, death at 90 days and rate of immediate complications post-procedure. Overall, our cohort included 518 patients with acute ischemic stroke and LVO treated with MT, with 289 (56.8%) without a diagnosis of AF; 107 (21%) with AFDAS; 122 (22.2%) with KAF. There was no significant difference in terms of functional independence at 90 days after stroke between the three groups. Regarding the secondary study outcome, the rate of symptomatic intracranial haemorrhage (sICH) and/or parenchymal hematoma (PH) were significantly higher in the group of patients without AF (respectively, P = 0.030 and < 0.010). Logistic regression analysis showed that the subtypes of AF were not statistically significantly associated with functional independence at 90 days after stroke and with the likelihood of any ICH. Our results suggest that the subtypes of AF are not associated with clinical and safety outcomes of MT in patients with acute stroke and LVO. Further studies are needed to confirm our findings.
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D’Anna et al. (2023) conducted an observational in Acute ischemic stroke due to large vessel occlusion (n=518). Atrial fibrillation detected after stroke (AFDAS) vs. Known atrial fibrillation (KAF) and no atrial fibrillation was evaluated on Functional independence at 90 days after stroke (mRS scores of 0-2) (p=0.311). Atrial fibrillation detected after stroke was not associated with a significant difference in functional independence at 90 days compared to known atrial fibrillation or no atrial fibrillation in patients undergoing mechanical thrombectomy.
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