EFFECTS OF ATRIAL FIBRILLATION TYPE ON THE ISCHEMIC STROKE RECOVERY PERIOD COURSE IN THE PATIENTS WITH ARTERIAL HYPERTENSION

Abstract

Objective: evaluation of the effects of atrial fibrillation (AF) type on the course of ischemic stroke (IS) recovery period in the patients with arterial hypertension (AH). Design and method: We performed retrospective analysis in 86 patients with AH in the IS recovery period with the anamnesis of non-valvular AF (mean age 56,4 ± 7,6 years; 79% men, 21% women). Patients were of two groups: 1) with persistent/constant AF (73%); 2) patients with paroxysmal AF (27%). Rankin scale was used to determine the degree of disability; Bartel index for social adaptation degree evaluation. Results: In group 1: 44,8% received continuous antiaggregants before index event, 5,6% - anticoagulants, 32,8% - regular antihypertensive treatment, 3,3% - statins; acute period Rankin score was 3,3 ± 0,87, Bartel index - 54,3 ± 9,4. Group 2: 16,3% received regular antihypertensive treatment, 2,5% - statins, 75% - antiaggregants, anticoagulants - none (Rankin score was 2,9 ± 0,87, Bartel index 65,8 ± 8,86). Recovery period. Group 1: 47% took oral anticoagulants, 58,0% - antihypertensive treatment, 26,0% - statins (the latter - all men). Group 2: corresponding percentage for meds classes were 0%, 80,0% and 25,0%, respectively. Comparison of functional status in groups 1 and 2: Rankin scale 2,8 ± 0,96 vs. 1,8 ± 0,83, Barthel index 62,1 ± 12,5 vs. 72,5 ± 8,86. The recurrent IS occurrence during the first year in groups 1 and 2: 38,5% vs. 25,0%, in 2 years – 16,7% vs. 25,0%, respectively. Group 1 showed significant reduction in adherence to treatment with anticoagulants and statins (47,0% vs. 15,4%, and 26,0% vs. 7,7%), with growing complience to antihypertensive treatment (58,0% vs. 76,0%). Group 2: maximum reduction in compliance was for antihypertensive treatment (80,0% vs. 66,7%) and statins (25,0% vs. 0,0%). Conclusions: Patients with AH and persistent/constant AF in IS recovery show higher degree of disability, as well as lower functional independence class vs. patients with paroxysmal AF. Patients with AH after IS regardless of AF form showed lower adherence degree to medication treatment, which is surely is one of the recurrent IS risk factor.