Document Detail


Characteristics, Treatment and Outcome of Ischemic Stroke with Atrial Fibrillation in a Chinese Hospital-Based Stroke Study.
MedLine Citation:
PMID:  21346346     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: There is scant information on characteristics, treatment, functional outcome and case fatality of ischemic stroke with atrial fibrillation (AF) in China. Methods: For this study, first-ever ischemic stroke patients who were admitted within 1 month of stroke onset during the period of March 2002 through December 2008 were included. Data on ischemic stroke patients were collected which included: demographics, risk factors, treatment administered, stroke-related complications and 3-month, 6-month and 1-year death and disability. Multivariate regression models were used to analyze predictors for death and disability. Results: Of the 2,683 patients included in this study, 366 (13.6%) had AF. In this group, valvular AF was observed in 153 (41.8%) patients. Compared to patients without AF, patients with AF were older (66.1 vs. 63.6, p = 0.001) and had a higher NIHSS score on admission (median 10 vs. 4, p < 0.001) and more frequently suffered from hemorrhagic transformation (7.3 vs. 2.8%, p < 0.001), pulmonary infection (27 vs. 10.6%, p < 0.001), urinary tract infection (8.5 vs. 3.0%, p < 0.001), acute gastrointestinal tract hemorrhage (4.1 vs. 1.9%, p = 0.008), electrolyte disturbance (5.2 vs. 1.8%, p < 0.001), acute renal failure (1.1 vs. 0.5%, p = 0.005) and urinary incontinence (3.8 vs. 0.6%, p < 0.001) during hospitalization. The percentages of patients with AF who received oral anticoagulants were 3.3% before stroke onset and 14.2% at discharge. Moreover, patients with AF had a higher proportion of disability (determined as modified Rankin Scale score 3-5) in 3-month, 6-month and 1-year follow-ups (46.6, 41.9 and 37.6 vs. 29.1, 24.0 and 19.3%, respectively, p < 0.001) and higher case fatality in hospitalization, 3-month, 6-month and 1-year follow-ups (10.1, 25.5, 29.1 and 34.0 vs. 2.0, 7.4, 8.8 and 11.6%, respectively, p < 0.001). Multivariate logistic regression determined that AF, age and NIHSS score were the independent predictors for the 3-month, 6-month and 1-year death. Conclusions: Ischemic stroke patients with AF have a poorer outcome, a higher frequency of stroke-related complications and a higher case fatality than patients without AF. Oral anticoagulants were underused in AF patients.
Authors:
Sen Lin; Bo Wu; Zi-Long Hao; Fan-Yi Kong; Wen-Dan Tao; De-Ren Wang; Sha He; Ming Liu
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-23
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  31     ISSN:  1421-9786     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  419-426     Citation Subset:  -    
Copyright Information:
Copyright © 2011 S. Karger AG, Basel.
Affiliation:
Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, PR China.
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