Long-Term Outcomes after Stroke in Patients with Atrial Fibrillation: A Single Center Study

Abstract

Atrial fibrillation (AF) is known to be a significant risk factor for poor prognosis after stroke. In this study, we compared differences in long-term outcomes after ischemic stroke among patients with AF and sinus rhythm (SR). We identified patients admitted to the reference Neurology Center between 1 January 2013 and 30 April 2015, inclusive, with acute ischemic stroke. Of the 1959 surviving patients, 892 were enrolled and followed for five years or until death. We analyzed the risk of stroke recurrence and death between patients with AF and SR at 1, 3, and 5 years after stroke. The rates of death and stroke recurrence were estimated using Kaplan–Meier analysis and multivariate Cox regression. During follow-up, 17.8% of patients died and 14.6% had recurrent stroke. The mortality in the AF group increased relative to the SR group with subsequent years. The risk of death was statistically higher in the AF than SR group at 1 year after stroke (13.5 vs. 7%, p = 0.004). After adjusting for age, stroke severity, and comorbidities, there was also no significant effect of AF on mortality in the first year after stroke (OR = 1.59, p = 0.247). There were no significant differences between the groups in stroke recurrence during follow-up. The results of our study showed that post-stroke patients with AF have a more severe prognosis, although AF itself does not have an independent negative effect on long-term outcomes after stroke. Long-term survival after stroke in patients with AF was strongly associated with age, stroke severity, and heart failure. The impact of other factors on prognosis after stroke in patients with AF should be considered.

Risk Factors of In-Hospital Mortality of Ischemic Stroke Patients in Gunung Jati General Hospital

“…The worse prognosis in the AF group was observed to be related to older age and multi-comorbidities in those groups. 17 CKD also notably showed higher in patients with in-hospital mortality in this study. Patients face a 30fold increased risk of stroke morbidity and a case mortality rate of nearly 90%.…”

Development and Validation of a Dynamic Nomogram for Predicting 3-Month Mortality in Acute Ischemic Stroke Patients with Atrial Fibrillation

“…Our findings were consistent with previous studies, highlighted age and NIHSS score as primary independent risk factors for short-and long-term mortality in patients with ischemic stroke (IS) and AF. [29][30][31][32][33] Age is closely intertwined with stroke incidence and severity. 34 Previous researches reported that the mortality of patients with stroke rose with age.…”

Diagnosis and Management of Atrial Fibrillation in Acute Ischemic Stroke in the Setting of Reperfusion Therapy: Insights and Strategies for Optimized Care

“…However, multivariate analysis revealed that this association was mostly due to the increased age and greater initial stroke severity in AF patients. A recent study investigating long-term prognosis in AIS patients with and without AF demonstrated a significantly higher rate of one-year mortality post-stroke in AF patients [102]. Similarly, this association was no longer significant after adjusting for comorbidities such as heart failure and the greater age and baseline stroke severity in AF patients.…”