Key result
Acute AF at stroke onset is linked to ~4.1-fold higher odds of 30-day mortality.
Why the study?
The prognostic impact of acute atrial fibrillation at the onset of acute ischemic stroke remains unclear.
Does acute atrial fibrillation at the onset of acute ischemic stroke independently increase the risk of short-term mortality and severe early neurological deficits compared to pre-existing or no atrial fibrillation?
Cohort (n=417)
No
Does acute atrial fibrillation at the onset of acute ischemic stroke independently increase the risk of short-term mortality and severe early neurological deficits compared to pre-existing or no atrial fibrillation?
Odds Ratio: 4.11 (95% CI 2.28–7.43)
Absolute Event Rate: 41.7% vs 10.8%
p-value: p=<0.001
New-onset acute atrial fibrillation identified at the time of acute ischemic stroke is a powerful independent predictor of short-term mortality and severe early neurological deterioration.
Acute AF marks high short-term mortality risk in ischemic stroke; observational data leave open whether targeted interventions improve outcomes.
Background Atrial fibrillation (AF) is an important risk factor for ischemic stroke. However, the prognostic impact of acute atrial fibrillation (AAF) at the onset of acute ischemic stroke (AIS) remains unclear. Methods This retrospective study categorized 417 patients with AIS into the AAF ( n = 72), other AF ( n = 142), and non-AF ( n = 203) groups. Multivariate logistic regression analysis of associations with 30-day all-cause mortality and severe early neurological deficit (7-day NIHSS ≥16). Results The AAF group demonstrated significantly worse outcomes than the other AF and non-AF groups. In the multivariable analysis, AAF was identified as an independent risk predictor for severe 7-day neurological deficit [odds ratio (OR): 10.09; 95% CI: 3.87−27.36; P < 0.001] and all-cause mortality within 30 days (OR: 4.11; 95% CI: 2.28−7.43; P < 0.001). Conclusions AAF at the onset of AIS is an independent risk predictor for early neurological deterioration and short-term mortality, establishing it as a crucial prognostic indicator that warrants vigilant management.
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Duan et al. (2026) conducted a cohort in Acute ischemic stroke (n=417). Acute atrial fibrillation (AAF) vs. Non-atrial fibrillation (Non-AF) was evaluated on 30-day all-cause mortality (OR 4.11, 95% CI 2.28-7.43, p=<0.001). Acute atrial fibrillation at the onset of acute ischemic stroke independently increased the odds of 30-day all-cause mortality by over 4-fold compared to patients without atrial fibrillation.
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