Abstract
Background and aims: Atrial fibrillation (AF) is a major cause of ischemic stroke; however, detailed clinical data and prognostic factors for stroke patients with AF are lacking in Korea. We aimed to investigate clinical information and factors associated with functional outcomes of stroke patients with AF from the Korean nationwide ATrial fibrillaTion EvaluatioN regisTry in Ischemic strOke patieNts (K-ATTENTION) database.Methods: From January 2013 to December 2015, consecutive clinical information from acute stroke patients with AF or history of AF was collected from 11 centers in Korea. Collected data included demographics, risk factors, pre-stroke medication, stroke severity, stroke subtypes, concomitant cerebral atherosclerosis, brain image findings, recanalization therapy, discharge medication, and functional outcome at 3 months after index stroke.Results: A total of 3,213 stroke patients (mean age, 73.6 ± 9.8 years; female, 48.6%) were included. The mean CHA2DS2-VASc score was 4.9. Among the 1,849 (57.5%) patients who had brain image and functional outcome data, poor outcome (modified Rankin scale > 2) was noted in 53.1% (981/1,849) of patients. After adjusting for age, sex, and variables that had a p < 0.05 in univariate analysis or well-known factors for functional outcome, presence of asymptomatic extracranial cerebral atherosclerosis [odd ratio (OR): 1.96, 95% confidence interval (CI): 1.36–2.82, p = 0.001] and less frequent prior stroke statin intake (OR: 0.69, 95% CI: 0.49–0.98, p = 0.038) were associated with poor functional outcome.Conclusion: Our results suggest that presence of non-relevant extracranial cerebral atherosclerosis may affect poor functional outcome and prior stroke statin therapy may be feasible in Korean stroke patients with AF.
Highlights
Atrial fibrillation (AF) is frequent cardiac arrhythmia and is associated with increased risk of systemic embolism, hospitalization, and death [1, 2]
We aimed to demonstrate demographics and outcome parameters and to investigate factors associated with early functional outcomes of stroke patients with AF from the Korean nationwide ATrial fibrillaTion EvaluatioN regisTry in Ischemic strOke patieNts (K-ATTENTION) database
Etiologic stroke classification among patients who were classified into stroke subtypes was 76.2% (2,450/3,213), the AF only group comprised 83.8% (2,053/2,450), and was followed by two or more causes [atherosclerotic 12.2% (298/2,450), small vessel occlusion 3.0% (74/2,450), and other (1.0% (25/2,450)]
Summary
Atrial fibrillation (AF) is frequent cardiac arrhythmia and is associated with increased risk of systemic embolism, hospitalization, and death [1, 2]. AF is a well-known major risk factor for occurrence and recurrence of stroke and stroke-related mortality [3]. The functional outcome of AF patients with acute stroke is a major determinant of mortality and long-term recurrence and the decision whether to use oral anticoagulants is dependent on the neurological status and findings obtained from neuroimaging rather than conventional risk stratification schemes such as CHA2DS2-VASc score. Atrial fibrillation (AF) is a major cause of ischemic stroke; detailed clinical data and prognostic factors for stroke patients with AF are lacking in Korea. We aimed to investigate clinical information and factors associated with functional outcomes of stroke patients with AF from the Korean nationwide ATrial fibrillaTion EvaluatioN regisTry in Ischemic strOke patieNts (K-ATTENTION) database
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