The clinical outcome comparison of ischemic stroke with and without atrial fibrillation

Abstract

Background: Atrial fibrillation increases the risk of stroke and is associated with poor stroke outcomes. The primary concern of this study was to compare the clinical outcome of ischemic stroke patients with atrial fibrillation and without atrial fibrillation.Methods: This was a retrospective cohort study using secondary data from electronic medical record and electronic stroke registry of Bethesda Hospital Yogyakarta, Indonesia. The data was collected from 2017-2018. The presence of atrial fibrillation at stroke onset and during the acute phase was confirmed by a standard electrocardiogram. The primary outcomes of the study was in-hospital mortality, disability measured by modified Rankin Scale (mRS), and length of stay. We used SPSS 20 with significance level 0,05.Results: Among 1688 patients with ischemic stroke, 45(2,67%) had atrial fibrillation. 51,11% of patients with AF were males and 82,22% aged above 60 years. The mortality of stroke patients with atrial fibrillation group is eighteen patients (40.0%), thirty seven patients (84.4%) have poor functional outcome (mRS≥2) and have length of stay 6 (0-41) days. Bivariate analysis showed stroke patients with atrial fibrillation group is significantly associated with higher inhospital mortality (RR: 2.11; 95% CI: 1.09-2.22; p: 0.001), worse disability (RR: 2.09; 95% CI: 1.92-2.32; p: 0.001) and prolonged hospital stay (6 (0-41) vs 4 (0-14), p:0.001) than in stroke patients without atrial fibrillation group. Conclusion:Atrial fibrillation is associated with stroke outcomes. Careful cardiac evaluation and appropriate treatment are needed to improve the poor outcomes in patients with ischemic stroke and atrial fibrillation.

Prevalence and Factors Associated with Atrial Fibrillation in Patients with Transient Ischemic Attack or Ischemic Stroke in Northern Vietnam

“…The prevalence of AF in our study was found to be 18.4%, further affirming its role as one of the leading causes of cerebral infarction and transient ischemic attack (TIA) according to the TOAST classification [13]. This rate is relatively high when compared to other studies conducted in Vietnam and Southeast Asian countries such as Thailand, Malaysia, Singapore, and Indonesia [3][4][5][6][7]. However, the mean age and male predominance observed in our study were comparable to these aforementioned studies.…”

“…Studies in Western countries in patients with TIA/ischemic stroke report an AF prevalence ranging between 20.4% and 33.4% [2]. Meanwhile, studies in Southeast Asia recorded an AF rate in a lower range from 5.8% to 23.4% [3][4][5][6][7]. Therefore, screening for AF plays an essential role in the primary and secondary prevention of stroke.…”