Key result
Atrial fibrillation was associated with significantly higher initial stroke severity (median NIHSS 12 vs 9) compared to patients without atrial fibrillation, though mortality did not differ.
Why the study?
Atrial fibrillation is a major risk factor for ischemic stroke, making it important to verify its effect on stroke severity and outcomes.
Does the presence of atrial fibrillation increase stroke severity and worsen outcomes in patients with acute stroke?
Observational (n=200)
No
Does the presence of atrial fibrillation increase stroke severity and worsen outcomes in patients with acute stroke?
Absolute Event Rate: 12% vs 9%
p-value: p=0.006
Patients with atrial fibrillation experience more severe strokes with higher initial neurologic deficits compared to those without AF, though in-hospital mortality and functional status at discharge may not differ significantly.
AF associated with greater acute stroke severity but similar short-term outcomes; leaves open whether AF modifies thrombolysis response in prospective cohorts.
Background Atrial fibrillation (AF) is a major risk factor for ischemic stroke. It is important to verify the effect of AF on the outcomes of stroke. Objective To compare stroke severity and outcomes regarding stroke victims with and without AF. Methods Analysis of the medical data (including age, sex, stroke type, localization, treatment method, severity and outcomes of the stroke (according to the National Institutes of Health Stroke Scale (NIHSS) score, Barthel index score, death), antithrombotic treatment) of 200 stroke patients (100 with AF, 100 without AF). Results Patients with AF were older than non-AF patients (76.19 ± 9.4 vs. 66.99 ± 11.7, p<0.001), there were more women among them (63 vs. 39, p=0.01). 53 patients with AF had used anticoagulants (AC) before stroke (most of them were used ineffectively), 99 had had indications to use them. The distribution of the type of the stroke did not differ significantly between groups. AF patients had stroke in the area of the brain supplied by the carotid artery more often (95% vs. 78%, p<0.001). Initial stroke severity (p=0.006), NIHSS after thrombolysis (p=0.008), NIHSS 7 days after thrombolysis (p=0.01) was higher in AF patients; Barthel index score (p=0.194) and mortality (p=0.323) did not differ. Conclusion Patients with AF experienced more severe strokes and presented higher neurologic deficits than patients without this condition. Nevertheless, the mortality and patients' final functional status did not differ. AC usage in patients with AF did not alleviate neurologic deficits and stroke outcomes possibly due to their insufficient usage.
No takes yet. Share an insight, caveat, or question.
Ragelytė et al. (2019) conducted an observational in Stroke (n=200). Atrial fibrillation vs. No atrial fibrillation was evaluated on Initial stroke severity (median NIHSS score before thrombolysis) (p=0.006). Atrial fibrillation was associated with significantly higher initial stroke severity (median NIHSS 12 vs 9) compared to patients without atrial fibrillation, though mortality did not differ.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: