Key result
Permanent atrial fibrillation was associated with a significantly higher risk of unfavorable short-term outcomes after ischemic stroke compared to paroxysmal atrial fibrillation (OR 5.4; P<0.01).
Why the study?
Do patients with paroxysmal atrial fibrillation have better ischemic stroke outcomes compared to those with permanent atrial fibrillation?
Cohort (n=178)
No
Do patients with paroxysmal atrial fibrillation have better ischemic stroke outcomes compared to those with permanent atrial fibrillation?
Ischemic strokes in patients with paroxysmal atrial fibrillation are associated with more favorable short- and long-term outcomes compared to those with permanent atrial fibrillation.
Answers are grounded in this paper and cite their sources.
May signal higher short-term post-stroke risk with permanent versus paroxysmal AF; leaves open causal role and management implications.
OBJECTIVE: Our aim was to compare the course of IS due to ptAF and pxAF. METHODS: A prospective, single-center study was conducted in patients with AF and acute IS with 6-month follow-up. RESULTS: We included 178 patients: 70 (39%) with pxAF and 108 (61%) with ptAF. Compared with patients with ptAF, patients with pxAF more often presented with subcortical, mainly lacunar strokes (21% vs 8%, P = 0.01) and were less frequently dependent at discharge (16% vs 42%, P < 0.001) and after 6 months (16% vs 20%, P < 0.001). Strokes in patients with pxAF were more frequently categorized as non-cardioembolic (35% vs 18%, P = 0.01). In the multivariate analysis, after adjustment for confounding factors (diabetes, chronic heart failure, high risk of thromboembolism and lack of prestroke anticoagulation), ptAF was an important risk factor for unfavorable short-term (OR 5.4; P < 0.01) and long-term outcomes (OR 2.6, P = 0.01) of IS. In all patients with AF, the occurrence of non-cardioembolic stroke was related to a reduced risk of dependence or death in short-term outcome (OR 0.4, P = 0.04) and marginally influenced long-term outcome (OR 0.49, P = 0.09). CONCLUSIONS: The present study suggests that, compared with patients with ptAF, ISs in patients with pxAF have better outcomes.
No takes yet. Share an insight, caveat, or question.
Staszewski et al. (2009) conducted a cohort in Atrial fibrillation and acute ischemic stroke (n=178). Permanent atrial fibrillation (ptAF) vs. Paroxysmal atrial fibrillation (pxAF) was evaluated on Unfavorable short-term outcome (dependence at discharge) (OR 5.4, p=<0.01). Permanent atrial fibrillation was associated with a significantly higher risk of unfavorable short-term outcomes after ischemic stroke compared to paroxysmal atrial fibrillation (OR 5.4; P<0.01).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: