Abstract 17308: Leukoaraiosis is Associated With Atrial Fibrillation and Greater Disability at 90-days in Patients Hospitalized With a Cardioembolic Stroke

Abstract

Introduction: Atrial fibrillation (AF) has been associated with a poor post-stroke prognosis. AF has been linked to increased leukoaraiosis (LA) burden, which is associated with greater functional impairment after stroke. Hypothesis: We hypothesized that AF is associated with the severity of LA burden and thus impacts 90-day outcomes in patients hospitalized with acute cardioembolic ischemic stroke. Methods: We retrospectively analyzed 317 consecutive patients with acute cardioembolic ischemic stroke enrolled in the University of Massachusetts Medical Center’s Stroke Registry between 2010 and 2014. Stroke mechanism was determined according to the Causative Classification System. LA burden was graded on MRI using the Fazekas scale. Infarct volume was quantified on diffusion weighted images. Neurological deficit severity was assessed at admission according to the National Institutes of Health Stroke Scale (NIHSS). We evaluated the degree of disability using the modified Rankin score (mRS) at 90 days. Participants were categorized as having excellent (mRS 0-1), or poor (mRS 2-6) status. Results: A total of 132 patients were classified as having a definite (n=81) or probable (n=51) cardioembolic stroke. Of these, 54 (41%) had AF (previously known or newly documented). Compared to patients without AF, patients with AF were older (p=0.001), more likely to be receiving antihypertensives(p=0.008) and anticoagulants (p<0.05 each), were associated with a poor outcome at 90 days. Conclusions: We observed that AF was related to severity of LA and that LA burden was an independent predictor of significant disability 90-days post-discharge. Further study is needed to investigate the links between AF, LA, and outcomes after cardioembolic stroke.