January 1, 2023Ideggyógyászati SzemleOpen Access

Is there any difference in mortality rates of atrial fibrillation detected before or after ischemic stroke?

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Acute ischemic stroke (n=134). Intervention: Atrial fibrillation diagnosed after stroke (AFDAS) vs. Sinus rhythm (SR). Primary outcome: All-cause mortality (OR 1.839, 95% CI 0.641-5.278, p=0.257).

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Key result

Atrial fibrillation diagnosed after stroke (AFDAS) was associated with a similar 1-year mortality rate compared to sinus rhythm (OR 1.839, p=0.257), whereas known atrial fibrillation independently predicted higher mortality.

Why the study?

Atrial fibrillation diagnosed after stroke (AFDAS) is associated with lower stroke recurrence than known AF before stroke, but the characteristics and mortality rates of AFDAS patients required exploration.

Does atrial fibrillation diagnosed after stroke (AFDAS) increase mortality compared to known AF or sinus rhythm in acute ischemic stroke patients?

Population

134 consecutive ischemic stroke patients

Comparison

AFDAS vs known AF before stroke (KAF) vs sinus rhythm

Design

Cohort study

Follow-up

1 year

Authors

ÇİÇiğdem İleriLiv Hospital ZDZekeriya DoğanMarmara University BÖBeste ÖzbenMarmara University

Discussion

Member takes

Implication

AFDAS may warrant less intensive management than KAF post-stroke; hypothesis-generating and requires prospective validation before practice change.

Study Design

Type

Cohort (n=134)

Structured PICO

Does atrial fibrillation diagnosed after stroke (AFDAS) increase mortality compared to known AF or sinus rhythm in acute ischemic stroke patients?

Population

134 patients with acute ischemic stroke, followed for 1 year to compare mortality rates among those with known atrial fibrillation, atrial fibrillation diagnosed after stroke, and sinus rhythm.

Exposure

Atrial fibrillation diagnosed after stroke (AFDAS) - newly documented AF rhythm lasting more than 30 seconds in ambulatory ECG monitoring or daily 12-lead ECG (n=38).

Comparator

Known AF before stroke (KAF) with anticoagulant therapy (n=22) and patients with sinus rhythm (SR) (n=74).

Outcome

All-cause mortality at 1 year follow-up.hard clinical

Main Result

Odds Ratio: 1.839 (95% CI 0.641–5.278)

Absolute Event Rate: 28.9% vs 16.2%

p-value: p=0.257

Atrial fibrillation diagnosed after stroke (AFDAS) appears to be a relatively benign form of AF with mortality rates similar to sinus rhythm, unlike known AF which independently predicts higher mortality.

Limitations

Small sample size
Relatively short follow-up period
Could not investigate the differences between cardiogenic and neurogenic AFDAS subgroups due to small numbers
Excluded TIA patients, which might cause misdiagnosis of AFDAS
AF might be underestimated as patients did not undergo prolonged ambulatory ECG monitoring
Inability to investigate differences between cardiogenic and neurogenic AFDAS subgroups
Exclusion of TIA which might cause misdiagnosis of AFDAS
Lack of prolonged ambulatory ECG monitoring which might underestimate AF

Cite This Study

İleri et al. (2023) conducted a cohort in Acute ischemic stroke (n=134). Atrial fibrillation diagnosed after stroke (AFDAS) vs. Sinus rhythm (SR) was evaluated on All-cause mortality (OR 1.839, 95% CI 0.641-5.278, p=0.257). Atrial fibrillation diagnosed after stroke (AFDAS) was associated with a similar 1-year mortality rate compared to sinus rhythm (OR 1.839, p=0.257), whereas known atrial fibrillation independently predicted higher mortality.

synapsesocial.com/papers/6a9481205cc4cfd2f72de41f https://doi.org/10.18071/isz.76.0365

Topics

Atrial fibrillation Persistent AF management Anticoagulation in AF AF ablation outcomes

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January 1, 2023Ideggyógyászati SzemleOpen Access

Is there any difference in mortality rates of atrial fibrillation detected before or after ischemic stroke?

View Full Paper

Ask AI

Bookmark

Key result

Why the study?

Does atrial fibrillation diagnosed after stroke (AFDAS) increase mortality compared to known AF or sinus rhythm in acute ischemic stroke patients?

Population

134 consecutive ischemic stroke patients

Comparison

AFDAS vs known AF before stroke (KAF) vs sinus rhythm

Design

Cohort study

Follow-up

1 year

Authors

ÇİÇiğdem İleriLiv Hospital ZDZekeriya DoğanMarmara University BÖBeste ÖzbenMarmara University

Discussion

Member takes

Implication

AFDAS may warrant less intensive management than KAF post-stroke; hypothesis-generating and requires prospective validation before practice change.

Study Design

Type

Cohort (n=134)

Structured PICO

Does atrial fibrillation diagnosed after stroke (AFDAS) increase mortality compared to known AF or sinus rhythm in acute ischemic stroke patients?

Population

134 patients with acute ischemic stroke, followed for 1 year to compare mortality rates among those with known atrial fibrillation, atrial fibrillation diagnosed after stroke, and sinus rhythm.

Exposure

Atrial fibrillation diagnosed after stroke (AFDAS) - newly documented AF rhythm lasting more than 30 seconds in ambulatory ECG monitoring or daily 12-lead ECG (n=38).

Comparator

Known AF before stroke (KAF) with anticoagulant therapy (n=22) and patients with sinus rhythm (SR) (n=74).

Outcome

All-cause mortality at 1 year follow-up.hard clinical

Main Result

Odds Ratio: 1.839 (95% CI 0.641–5.278)

Absolute Event Rate: 28.9% vs 16.2%

p-value: p=0.257

Limitations

Small sample size
Relatively short follow-up period
Could not investigate the differences between cardiogenic and neurogenic AFDAS subgroups due to small numbers
Excluded TIA patients, which might cause misdiagnosis of AFDAS
AF might be underestimated as patients did not undergo prolonged ambulatory ECG monitoring
Inability to investigate differences between cardiogenic and neurogenic AFDAS subgroups
Exclusion of TIA which might cause misdiagnosis of AFDAS
Lack of prolonged ambulatory ECG monitoring which might underestimate AF

Cite This Study

synapsesocial.com/papers/6a9481205cc4cfd2f72de41f https://doi.org/10.18071/isz.76.0365

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

Topics

Atrial fibrillation Persistent AF management Anticoagulation in AF AF ablation outcomes

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