Acute Stroke With Atrial Fibrillation

Jørgensen, Henrik; Nakayama, Hirofumi; Reith, Jakob; Raaschou, Hans Otto; Olsen, Tom Skyhøj

doi:10.1161/01.str.27.10.1765

Cited by 452 publications

(295 citation statements)

References 32 publications

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“…Pre-existing congestive heart failure [32][33][34] and atrial arrhythmia 32,33,[35][36][37] are well-documented risk factors for mortality after stroke, and our findings suggest a prognostic significance of these conditions in thrombolysis patients. However, in our study, the increased risk of mortality attributable to these conditions is very similar in thrombolysis and nonthrombolysis patients, suggesting that these conditions should probably not be considered contraindications to thrombolysis.…”

Section: Bateman Et Al Thrombolysis Nationwide Inpatient Samplesupporting

confidence: 54%

Factors Associated With In-Hospital Mortality After Administration of Thrombolysis in Acute Ischemic Stroke Patients

Bateman

Schumacher

Boden‐Albala

et al. 2006

Stroke

111

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Background and Purpose-The prospective trials evaluating the safety and efficacy of intravenous tissue plasminogen activator have generally been conducted at academic medical centers and community hospitals with an institutional commitment to stroke care. Relatively little is known about the safety of this therapy as it is used in the community. We therefore examined outcomes in acute stroke patients treated with thrombolysis using the largest discharge database available in the United States for the years 1999 to 2002. Methods-Data were derived from the Nationwide Inpatient Sample for the years 1999 to 2002. Using the appropriateInternational Classification of Disease-Clinical Modification, 9th revision, codes, patients admitted through the emergency room with a primary diagnosis of acute ischemic stroke were selected for analysis. From these patients, those coded as receiving thrombolysis were identified. Multivariate logistic regression was performed on the thrombolysis and nonthrombolysis cohorts to identify independent predictors of in-hospital mortality from among those clinical elements available in the database. Results-We identified 2594 patients treated with thrombolysis from a group of 248 964 patients admitted through the emergency room with a primary diagnosis of acute ischemic stroke. The thrombolysis cohort had a higher in-hospital mortality rate compared with the nonthrombolysis patients (11.4% versus 6.8%). The rate of intracerebral hemorrhage was 4.4% for the thrombolysis cohort and 0.4% for nonthrombolysis patients. Multivariate logistic regression showed advanced age, Asian/Pacific Islander race, congestive heart failure, and atrial fibrillation/flutter to be independent predictors of in-hospital mortality after thrombolysis. Thrombolysis volume, overall ischemic stroke volume, and teaching status were not significant predictors of in-hospital mortality after thrombolysis. Conclusions-Thrombolysis, as it is used in the community, has a safety profile that is similar to that observed in the large, prospective clinical trials. (Stroke. 2006;37:440-446.)

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Section: Bateman Et Al Thrombolysis Nationwide Inpatient Samplesupporting

confidence: 54%

Factors Associated With In-Hospital Mortality After Administration of Thrombolysis in Acute Ischemic Stroke Patients

Bateman

Schumacher

Boden‐Albala

et al. 2006

Stroke

111

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“…7 The Copenhagen Stroke Study (a prospective, community-based study of 1197 patients with acute stroke) demonstrated that patients with AF had a higher mortality rate (OR, 1.7; 95% CI, 1.2 to 2.5), longer hospital stays (50 days vs. 40 days, p<.001), and a lower discharge rate to their own homes (OR, 0.60; 95% CI, 0.44 to 0.85). 8 This study also demonstrated that neurological and functional outcomes were markedly poorer in patients with atrial fibrillation due to more severe strokes. 8 Vitamin K antagonists such as warfarin are highly effective in preventing stroke in patients with atrial fibrillation.…”

Section: Introductionmentioning

confidence: 61%

“…8 This study also demonstrated that neurological and functional outcomes were markedly poorer in patients with atrial fibrillation due to more severe strokes. 8 Vitamin K antagonists such as warfarin are highly effective in preventing stroke in patients with atrial fibrillation. Warfarin reduces the risk of stroke by two-thirds and mortality by one-quarter compared with control.…”

Section: Introductionmentioning

confidence: 61%

Left Atrial Appendage Thrombus in a Patient with Atrial Fibrillation on Apixiban Successfully Treated with Warfarin and Pulmonary Vein Isolation Ablation

Joseph¹,

Mahmoud²,

Naqvi³

et al. 2017

Heart Res Open J

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Atrial fibrillation (AF) is a common cardiac arrhythmia that can be seen in hospitalized patients. It has been shown to be a major risk factor for cardioembolic stroke, and therefore patients are frequently started on lifelong anticoagulation. The majority of patients benefit from either cardioverison or pulmonary vein isolation ablation. We herein describe the case of a 58-yearold male with a past medical history of atrial fibrillation surgery who presented to hospital for elective atrial fibrillation ablation after failed medical therapy and persistent symptoms. A transesphageal echocardiogram (TEE) prior to the procedure demonstrated a left atrial appendage clot despite patient's compliance with apixiban. Subsequently, the patient is started on warfarin therapy with a heparin bridge. A TEE performed 6 weeks after discharge showed resolution of the left atrial appendage clot allowing the ablation procedure to be successfully performed.

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“…Cardioembolic stroke due to atrial fibrillation (AF) is a common cause of ischemic stroke and is associated with high mortality or morbidity with subsequent disability [1][2][3]. Furthermore, AF is one of the strongest predictors of in-hospital mortality among patients with acute ischemic stroke [4].…”

Section: Introductionmentioning

confidence: 99%

Cardiac diastolic dysfunction predicts in-hospital mortality in acute ischemic stroke with atrial fibrillation

Tateishi

Tsujino

Hamabe

et al. 2014

Journal of the Neurological Sciences

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Acute Stroke With Atrial Fibrillation

Cited by 452 publications

References 32 publications

Factors Associated With In-Hospital Mortality After Administration of Thrombolysis in Acute Ischemic Stroke Patients

Factors Associated With In-Hospital Mortality After Administration of Thrombolysis in Acute Ischemic Stroke Patients

Left Atrial Appendage Thrombus in a Patient with Atrial Fibrillation on Apixiban Successfully Treated with Warfarin and Pulmonary Vein Isolation Ablation

Cardiac diastolic dysfunction predicts in-hospital mortality in acute ischemic stroke with atrial fibrillation

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