Key result
Among patients with acute ischemic stroke, cigarette smoking was strongly associated with concurrent nonvalvular atrial fibrillation (OR 41.1), along with hypertension and prior stroke.
Why the study?
Classical risk factors for AF are also recognized risk factors for ischemic stroke, prompting investigation into AF risk factors specifically in patients with ischemic stroke.
Observational (n=2,374)
No
Odds Ratio: 41.1 (95% CI 29.667–57.914)
p-value: p=<0.01
Traditional cardiovascular risk factors, particularly smoking, hypertension, and previous stroke, are strongly associated with the presence of nonvalvular atrial fibrillation in patients presenting with acute ischemic stroke, highlighting the need for rigorous AF screening in this population.
May warrant AF screening consideration in smokers with acute stroke; extends associations but leaves causal impact and screening benefit open.
Introduction Atrial fibrillation (AF) is the most common heart arrhythmia. The condition is known to increase the risk of ischemic stroke (IS). Classical risk factors for the development of AF include advanced age, hypertension, diabetes mellitus, coronary heart disease and lipid metabolism disorders. Importantly, these are also recognized risk factors for ischemic stroke. Therefore, the purpose of this study was to investigate AF risk factors in patients with IS. Material and methods This is single-centre retrospective study which included 696 patients with acute ischemic stroke and nonvalvular atrial fibrillation and 1678 patients with acute ischemic stroke without atrial fibrillation. Results In this study we found – based on a univariable and multivariable logistic regression model – that compared to the patients with IS without AF, the group of patients which suffered from IS with nonvalvular atrial fibrillation (NVAF) had a higher proportion of patients who smoked cigarettes (OR = 15.742, p < 0.01; OR = 41.1, p < 0.01), had hypertension (OR = 5.161, p < 0.01; OR = 5.666, p < 0.01), history of previous stroke (OR = 3.951, p < 0.01; OR = 4.792, p < 0.01), dyslipidemia (OR = 2.312, p < 0.01; OR = 1.592, p < 0.01), coronary heart disease (OR = 2.306, p < 0.01; OR = 1.988, p < 0.01), a greater proportion of female patients (OR = 1.717, p < 0.01; OR = 2.095, p < 0.01), higher incidence of diabetes mellitus (OR = 1.341, p < 0.01; OR = 1.261, p = 0.106) and more patients in old age (OR = 1.084, p < 0.01; OR = 1.101, p < 0.01). Conclusions Our study demonstrates a need for thorough and systematic monitoring of post-ischemic stroke patients in whom AF has not been detected and who display other important risk factors. Regardless of the stroke, these factors may be responsible for development of AF.
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Wańkowicz et al. (2019) conducted an observational in Acute ischemic stroke (n=2,374). Cigarette smoking vs. Non-smokers was evaluated on Presence of nonvalvular atrial fibrillation (OR 41.1, 95% CI 29.667-57.914, p=<0.01). Among patients with acute ischemic stroke, cigarette smoking was strongly associated with concurrent nonvalvular atrial fibrillation (OR 41.1), along with hypertension and prior stroke.
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