Early Antidepressant Treatment and All-Cause 30-Day Mortality in Patients with Ischemic Stroke

Background: Antidepressants, in particular selective serotonin reuptake inhibitors, have been associated with antithrombotic and neuroprotective properties and their more widespread use has been suggested in stroke recovery. However, data are sparse on their effects on the clinical outcome, including mortality, associated with early antidepressant treatment after stroke. We aimed to study all-cause 30-day mortality related to early antidepressant treatment in patients with ischemic stroke. Methods: We did a population-based follow-up study identifying patients from the Danish Stroke Registry admitted in the former Aarhus County from 2003 to 2010. During this time, initiation of antidepressant treatment during admission was registered in the Danish Stoke Registry. The registry also holds clinical information including stroke type, stroke severity and quality of in-hospital stroke care. Information on vital status and covariates including comorbidities and co-medication was obtained from the following population-based medical registries: the Danish Civil Registration System, Danish Medicines Agency's Medical Register and The Danish National Patients Registry. Information was linked using the unique civil registration number assigned to all Danish residents. Multivariable logistic regression was used to compute the adjusted odds ratio (OR) of 30-day mortality in patients treated with antidepressants during admission as compared to patients not treated. In addition, we did stratified analyses on sex, age, stroke severity and propensity score-matched analyses as well as multiple imputation. Results: Among 5,070 consecutive first-ever stroke patients without prior antidepressant treatment, 955 (18.8%) started antidepressant treatment during admission with a median time from admission until treatment of 5 days (interquartile range 2-11). The proportion of patients with severe stroke was higher among treated patients as compared to that among non-treated patients. The adjusted OR of 30-day mortality was 0.28 (95% confidence interval (CI) 0.18-0.43) for patients treated during admission as compared to patients not treated during admission. Stratification by stroke severity showed signs of effect modification, stratification by sex and age did not. Included in the propensity score-matched analyses were 1,908 patients matched 1:1. The propensity score-matched adjusted OR of death within 30 days was 0.31 (95% CI 0.19-0.49). Conclusion: Although early antidepressant treatment was more often started in patients with severe stroke, treatment was associated with significantly lower mortality. This result requires replication in randomized trials; however, it indicates that early start of antidepressant treatment after stroke may be safe and a more routine use may be feasible.

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Predictors of Neurological and Functional Recovery in Patients with Moderate to Severe Ischemic Stroke: The EPICA Study

Stroke Research and Treatment ◽

10.1155/2020/1419720 ◽

2020 ◽

Vol 2020 ◽

pp. 1-13

Author(s):

Manuel Murie-Fernández ◽

Mercedes Molleda Marzo

Keyword(s):

Ischemic Stroke ◽

Dietary Supplement ◽

Functional Recovery ◽

Statistical Significance ◽

Stroke Recovery ◽

Control Group ◽

Stroke Severity ◽

Severe Stroke ◽

Nihss Score ◽

The Impact

Background. Improving our knowledge about the impact of restorative therapies employed in the rehabilitation of a stroke patient may help guide practitioners in prescribing treatment regimen that may lead to better post-stroke recovery and quality of life. Aims. To evaluate the neurological and functional recovery for 3 months after an acute ischemic stroke occurred within previous 3 months. To determine predictors of recovery. Design. Prospective observational registry. Population. Patients having suffered acute moderate to severe ischemic stroke of moderate to severe intensity within the previous 3 months with National Institutes of Health Stroke Scale (NIHSS) score from 10 to 20, 24 hours after arrival at emergency room (ER). Methods. All prespecified variables (sociodemographic and clinical data, lifestyle recommendations, rehabilitation prescription, and neurological assessments) were assessed at three visits, i.e., baseline (D0), one month (M1), and three months (M3). Results. Out of 143 recruited patients, 131 could be analysed at study entry within 3 months after stroke onset with a mean acute NIHSS score of 14.05, decreased to 10.8 at study baseline. Study sample was aged 64.9±13.8 years, with 49.2% of women. Neurorehabilitation treatment was applied to 9 of 10 patients from the acute phase and for three months with different intensities depending on the centre. A large proportion of patients recovered from severe dependency on activities of daily living (ADL) at D0 to a mild or moderate disability requiring some help at M3: mean NIHSS=10.8 to 5.7; median modified Rankin Scale mRS=4 to 3; Barthel index BI=40 to 70; all p values<0.001. Multivariate analyses integrating other regression variables showed a trend in favour of rehabilitation and revascularization therapies on recovery although did not reach statistical significance and that the positive predictors of recovery improvement were baseline BI score, time to treatment, and dietary supplement MLC901 (NurAiD™II). A larger percentage of patients with more severe stroke (NIHSS>14) who received MLC901 showed above median improvements on mRS compared to control group at M1 (71.4% vs. 29.4%; p=0.032) and M3 (85.7% vs. 50%; p=0.058). Older subjects and women tend to have less improvement by M3. Conclusions. Our study in patients with moderate to severe stroke shows overall recovery on neurological and functional assessments during the 3 months of study observation. Apart from demonstrating traditional “non-modifiable” predictors of outcome after stroke, like age, sex, and stroke severity, we also detected association between the use of dietary supplement MLC901 and recovery.

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Acute cardiovascular events and all-cause mortality in patients with hyperthyroidism: a population-based cohort study

Acta Endocrinologica ◽

10.1530/eje-16-0576 ◽

2017 ◽

Vol 176 (1) ◽

pp. 1-9 ◽

Cited By ~ 19

Author(s):

Olaf M Dekkers ◽

Erzsébet Horváth-Puhó ◽

Suzanne C Cannegieter ◽

Jan P Vandenbroucke ◽

Henrik Toft Sørensen ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cohort Study ◽

Ischemic Stroke ◽

Cardiovascular Events ◽

Population Based ◽

Arterial Embolism ◽

Registration System ◽

Increased Risk ◽

All Cause Mortality

Objective Several studies have shown an increased risk for cardiovascular disease (CVD) in hyperthyroidism, but most studies have been too small to address the effect of hyperthyroidism on individual cardiovascular endpoints. Our main aim was to assess the association among hyperthyroidism, acute cardiovascular events and mortality. Design It is a nationwide population-based cohort study. Data were obtained from the Danish Civil Registration System and the Danish National Patient Registry, which covers all Danish hospitals. We compared the rate of all-cause mortality as well as venous thromboembolism (VTE), acute myocardial infarction (AMI), ischemic and non-ischemic stroke, arterial embolism, atrial fibrillation (AF) and percutaneous coronary intervention (PCI) in the two cohorts. Hazard ratios (HR) with 95% confidence intervals (95% CI) were estimated. Results The study included 85 856 hyperthyroid patients and 847 057 matched population-based controls. Mean follow-up time was 9.2 years. The HR for mortality was highest in the first 3 months after diagnosis of hyperthyroidism: 4.62, 95% CI: 4.40–4.85, and remained elevated during long-term follow-up (>3 years) (HR: 1.35, 95% CI: 1.33–1.37). The risk for all examined cardiovascular events was increased, with the highest risk in the first 3 months after hyperthyroidism diagnosis. The 3-month post-diagnosis risk was highest for atrial fibrillation (HR: 7.32, 95% CI: 6.58–8.14) and arterial embolism (HR: 6.08, 95% CI: 4.30–8.61), but the risks of VTE, AMI, ischemic and non-ischemic stroke and PCI were increased also 2- to 3-fold. Conclusions We found an increased risk for all-cause mortality and acute cardiovascular events in patients with hyperthyroidism.

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Abstract TP160: Predicting Bone Fracture After Stroke—The Fracture Risk After Ischemic Stroke (FRAC-Stroke) Score

Stroke ◽

10.1161/str.48.suppl_1.tp160 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Eric E Smith ◽

Jiming Fang ◽

Shabbir M Alibhai ◽

Peter M Cram ◽

Angela M Cheung ◽

...

Keyword(s):

Ischemic Stroke ◽

Fracture Risk ◽

Risk Score ◽

Cumulative Incidence ◽

Population Based ◽

World Health ◽

Stroke Severity ◽

Stroke Patients ◽

One Year ◽

Low Trauma Fracture

Background: Risk for low trauma fracture is increased by >30% after ischemic stroke. Additionally, in the IRIS trial pioglitazone therapy prevented ischemic stroke but increased fracture risk. We derived a risk score to predict risk of fracture one year after ischemic stroke. Methods: The Fracture Risk after Ischemic Stroke (FRAC-Stroke) Score was derived in 20,435 ischemic stroke patients from the Ontario Stroke Registry discharged from 2003-2012, using Fine-Gray competing risk regression. Candidate variables were medical conditions included in the validated World Health Organization FRAX risk score complemented by variables related to stroke severity. Registry patients were linked to population-based Ontario health administrative data to identify low trauma fractures (defined as any fracture of the femur, forearm, humerus, pelvis or vertebrae, excluding fractures resulting from trauma, motor vehicle accidents, falls from a height or in people with active cancer). The score was externally validated in 13,698 other ischemic stroke patients in the population-based Ontario stroke audit (2002-2012). Results: Mean age was 72; 42% were women. Low trauma fracture occurred within 1 year of discharge in 741/20435 (3.6%); cumulative incidence increased linearly throughout follow-up. Age, discharge modified Rankin score (mRS), and history of arthritis, osteoporosis, falls and previous fracture contributed significantly to the model. Model discrimination was good (c statistic 0.72). Including discharge mRS significantly improved discrimination (relative integrated discrimination index 8.7%). Fracture risk was highest in patients with mRS 3 and 4 but lowest in bedbound patients (mRS 5). From the lowest to the highest FRAC-Stroke quintile the cumulative incidence of 1-year low trauma fracture increased from 1% to 9%. Predicted and observed rates of fracture were similar in the external validation cohort. Conclusion: The FRAC-Stroke score allows the clinician to identify ischemic stroke patients at higher risk of low trauma fracture within one year. This information might be used to target patients for early bone densitometry screening to diagnose and manage osteoporosis, and to estimate baseline risk prior to starting pioglitazone therapy.

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Is healthcare-seeking with gynaecological alarm symptoms influenced by personal and professional relations? A Danish population-based, cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-033471 ◽

2020 ◽

Vol 10 (5) ◽

pp. e033471

Author(s):

Anja Schmidt Vejlgaard ◽

Sanne Rasmussen ◽

Dorte Ejg Jarbøl ◽

Kirubakaran Balasubramaniam

Keyword(s):

Social Network ◽

Population Based ◽

Cross Sectional Study ◽

Age Group ◽

Cross Sectional ◽

Registration System ◽

Healthcare Seeking ◽

Civil Registration ◽

Personal Relation ◽

Alarm Symptom

ObjectivesTo identify the personal and professional relations of women experiencing gynaecological alarm symptoms, to analyse if involving a personal relation is related to healthcare-seeking with gynaecological alarm symptoms, and to analyse if having an available social network is associated with involvement of this relation.DesignWeb-based, population-based, cross-sectional questionnaire survey.SettingThe general population in Denmark.ParticipantsThe study invited 100 000 individuals randomly drawn from the Danish Civil Registration System. Pregnant women and women who did not answer relevant questions about social network were excluded. A total of 5053 women who experienced at least one gynaecological alarm symptom were included in the study.Primary and secondary outcomes(1) Personal and professional relations that women experiencing gynaecological alarm symptoms involve; (2) the association between involving a personal relation and healthcare-seeking; and (3) the association between having an available social network and involvement of this relation.ResultsThe general practitioner (GP) was the most involved professional relation, while the spouse/partner was the most involved personal relation. When experiencing gynaecological alarm symptoms, more than 50% of women did not involve a professional relation and 20% did not involve a personal relation. For all four gynaecological alarm symptoms, the odds of involving the GP were higher in the oldest age group. Women were two to seven times more likely to involve their GP if they had personal relation involvement. No statistically significant association was found between having an available social network and involving the GP.ConclusionInvolving a personal relation in healthcare-seeking was associated with increased involvement of the GP, who consequently was the most involved professional relation when experiencing gynaecological alarm symptoms. Spouse/partner was the most involved personal relation. The oldest age group had the highest odds of involving the GP. No association was found between having an available social network and involving the GP.

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Predicting stroke severity with a 3-min recording from the Muse portable EEG system for rapid diagnosis of stroke

Scientific Reports ◽

10.1038/s41598-020-75379-w ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Cassandra M. Wilkinson ◽

Jennifer I. Burrell ◽

Jonathan W. P. Kuziek ◽

Sibi Thirunavukkarasu ◽

Brian H. Buck ◽

...

Keyword(s):

Ischemic Stroke ◽

Low Cost ◽

Minor Stroke ◽

Stroke Severity ◽

Stroke Patients ◽

Low Frequencies ◽

Severe Stroke ◽

High Frequencies ◽

Detection Tool ◽

Record Data

Abstract In this study, we demonstrated the use of low-cost portable electroencephalography (EEG) as a method for prehospital stroke diagnosis. We used a portable EEG system to record data from 25 participants, 16 had acute ischemic stroke events, and compared the results to age-matched controls that included stroke mimics. Delta/alpha ratio (DAR), (delta + theta)/(alpha + beta) ratio (DBATR) and pairwise-derived Brain Symmetry Index (pdBSI) were investigated, as well as head movement using the on-board accelerometer and gyroscope. We then used machine learning to distinguish between different subgroups. DAR and DBATR increased in ischemic stroke patients with increasing stroke severity (p = 0.0021, partial η2 = 0.293; p = 0.01, partial η2 = 0.234). Also, pdBSI decreased in low frequencies and increased in high frequencies in patients who had a stroke (p = 0.036, partial η2 = 0.177). Using classification trees, we were able to distinguish moderate to severe stroke patients and from minor stroke and controls, with a 63% sensitivity, 86% specificity and accuracy of 76%. There are significant differences in DAR, DBATR, and pdBSI between patients with ischemic stroke when compared to controls, and these effects scale with severity. We have shown the utility of a low-cost portable EEG system to aid in patient triage and diagnosis as an early detection tool.

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Higher Blood Glucose within the Normal Range Is Associated with More Severe Strokes

Stroke Research and Treatment ◽

10.1155/2012/659610 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Rolf J. Martin ◽

Rajiv R. Ratan ◽

Michael J. Reding ◽

Tom S. Olsen

Keyword(s):

Ischemic Stroke ◽

Blood Glucose ◽

Fasting Blood Glucose ◽

Vital Signs ◽

Functional Independence Measure ◽

Multiple Linear Regression Model ◽

Functional Independence ◽

Stroke Severity ◽

Severe Stroke ◽

Average Decrease

Background. Higher fasting blood glucose (FBG) concentrations in the hyperglycemic range are associated with more severe strokes. Whether this association also extends into patients with FBG in the normoglycemic range is unclear. We studied the association of stroke severity and FBG in normoglycemic patients with ischemic stroke in a median of 7 days after stroke when the initial glycemic stress response has resolved.Method and Material. Included were 361 nondiabetic ischemic stroke patients with admission fasting blood glucose within 70–130 mg/dL admitted into an acute stroke rehabilitation unit in a median of 7 days after stroke. Data including neuroimaging, vital signs, cardiovascular risk factors, and admission functional independence measure (AFIM) were recorded prospectively.Results. FBG correlated with stroke severity in the normoglycemic 70–130 mg/dL range (FBG-AFIM correlation coefficient−0.17;P=0.003). Odds ratio for more severe injury (below average AFIM score) was 2.02 for patients with FBG 110–130 mg/dL compared to FBG 70–90 mg/dL (95% confidence interval 1.10–3.73,P=0.022). Each mg/dL increase in FBG was associated with an average decrease of 0.25 FIM points. In a multiple linear regression model, FBG was associated with more severe stroke (P=0.002).Conclusion. One week after ischemic stroke, FBG within the normoglycemic range was associated with stroke severity.

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Effects of SSRI exposure on hemorrhagic complications and outcome following thrombolysis in ischemic stroke

International Journal of Stroke ◽

10.1177/1747493017743055 ◽

2017 ◽

Vol 13 (5) ◽

pp. 511-517 ◽

Cited By ~ 5

Author(s):

Christoph Schellen ◽

Julia Ferrari ◽

Wilfried Lang ◽

Marek Sykora

Keyword(s):

Ischemic Stroke ◽

Functional Outcome ◽

Selective Serotonin Reuptake Inhibitors ◽

Ad Hoc ◽

Binary Logistic Regression ◽

Tissue Type ◽

Bleeding Complications ◽

Stroke Severity ◽

Stroke Patients ◽

Hemorrhagic Complications

Background Selective serotonin reuptake inhibitors (SSRI) may interfere with platelet function, and pre-stroke SSRI treatment has been associated with increased hematoma volumes and mortality in hemorrhagic stroke patients. The effects of SSRI on the risk of hemorrhagic complications after thrombolysis in ischemic stroke patients are unclear. Aims To examine the effects of pre-stroke SSRI exposure on bleeding complications, functional outcome, and mortality following thrombolysis in ischemic stroke. Methods Data including standard demographic and clinical variables as well as baseline and follow-up stroke severity (measured by National Institutes of Health Stroke Score), functional outcome (measured by modified Rankin Scale) at 3 months, and mortality at 7 and 90 days were extracted from the Virtual International Stroke Trials Archive. Multivariable binary logistic regression was used for statistical analyses. Results Out of 1114 ischemic stroke patients treated with recombinant tissue-type plasminogen activator, 135 (12.1%) had previous SSRI exposure. Symptomatic intracranial hemorrhage occurred in 30 (2.7%) patients. Of those, 2 (1.5%, n = 135) were in the SSRI pretreatment group and 28 (2.9%, n = 979) were SSRI naive patients. Pre-stroke SSRI exposure in thrombolysed patients showed association with neither bleeding complications ( P = .58) nor functional outcome ( P = .38) nor mortality ( P = .65). Conclusions Results from this large retrospective ad hoc database cohort study indicate that pre-stroke SSRI exposure in ischemic stroke patients who receive thrombolytic treatment is not associated with bleeding complications, functional outcome, or mortality.

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Family history, place and season of birth as risk factors for schizophrenia in Denmark: A replication and reanalysis

The British Journal of Psychiatry ◽

10.1192/bjp.179.1.46 ◽

2001 ◽

Vol 179 (1) ◽

pp. 46-52 ◽

Cited By ~ 105

Author(s):

Carsten Bøcker Pedersen ◽

Preben Bo Mortensen

Keyword(s):

Family History ◽

Environmental Factors ◽

Population Level ◽

Population Based ◽

Individual Risk ◽

Place Of Birth ◽

Case Register ◽

Registration System ◽

Civil Registration ◽

History Of

BackgroundAlthough a family history of schizophrenia is the strongest individual risk factor for schizophrenia, environmental factors related to urbanicity may contribute to a substantial proportion of the population occurrence of the disease.AimsThis study replicates previous findings in four mutually exclusive Danish study populations, including out-patient information, ICD–10 diagnoses of schizophrenia, and a broader adjustment for mental illness in family members.MethodWe established a population-based cohort of 2.66 million Danish people using data from the Civil Registration System linked with the Psychiatric Case Register.ResultsOverall, 10 264 persons developed schizophrenia during the 50.7 million person-years of follow-up. The risk of schizophrenia was increased by urbanicity of place of birth and by family history of schizophrenia or other mental disorders.ConclusionsUrban–rural differences of schizophrenia risk were replicated and could not be associated with the potential sources of bias we assessed. Environmental factors underlying the effect of place of birth are major determinants of schizophrenia occurrence at the population level, although the effect of family history is the strongest at the individual level.

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Risk profile for drowning deaths in children in the Indian state of Bihar: results from a population-based study

Injury Prevention ◽

10.1136/injuryprev-2018-042743 ◽

2018 ◽

Vol 25 (5) ◽

pp. 364-371 ◽

Cited By ~ 3

Author(s):

Rakhi Dandona ◽

G Anil Kumar ◽

Sibin George ◽

Amit Kumar ◽

Lalit Dandona

Keyword(s):

Contextual Information ◽

Age Groups ◽

Population Based ◽

The Body ◽

Population Based Study ◽

Registration System ◽

Civil Registration ◽

Indian State ◽

Research Consortium ◽

Adjusted Incidence

BackgroundWe report on incidence of drowning deaths and related contextual factors in children from a population-based study in the Indian state of Bihar which estimated the causes of death using verbal autopsy (VA).MethodsInterviews were conducted for deaths in 1–14 years population that occurred from January 2012 to March 2014 in 109 689 households (87.1% participation) in 1017 clusters representative of the state. The Population Health Metrics Research Consortium shortened VA questionnaire was used for interview and cause of death was assigned using the SmartVA automated algorithm. The annualised unintentional drowning death incidence, activity prior to drowning, the body of water where drowning death had occurred and contextual information are reported.FindingsThe survey covered 224 077 children aged 1–14 years. Drowning deaths accounted for 7.2%, 12.5% and 5.8% of all deaths in 1–4, 5–9 and 10–14 years age groups, respectively. The adjusted incidence of drowning deaths was 14.3 (95% CI 14.0 to 14.7) per 100 000 children, with it being higher in urban (16.1, 95% CI 14.8 to 17.3) areas. Nearly half of the children drowned in a river (5.9, 95% CI 5.6 to 6.1) followed by in a pond (2.8, 95% CI 2.6 to 2.9). Drowning death incidence was the highest while playing (5.1, 95% CI 4.9 to 5.4) and bathing (4.0, 95% CI 3.8 to 4.2) with the former accounting for more deaths in 1–4 years age group. Sixty per cent of children were already dead when found. None of these deaths were reported to the civil registration system to obtain death certificate.InterpretationThe findings from this large representative sample of children document the magnitude of and variations in unintentional drowning deaths in Bihar. Urgent targeted drowning interventions are needed to address the risk in children. Gross under-reporting of drowning deaths in children in India needs attention.

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HUBUNGAN ANTARA RIWAYAT PENYAKIT JANTUNG DENGAN TINGKAT KEPARAHAN STROKE ISKEMIK AKUT PERTAMA KALI

Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia ◽

10.52386/neurona.v37i1.101 ◽

2019 ◽

Vol 37 (1) ◽

Author(s):

Ignatius Ivan ◽

Budi Riyanto Wreksoatmodjo ◽

Octavianus Darmawan

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Atrial Fibrillation ◽

Heart Disease ◽

Ischemic Stroke ◽

National Institutes Of Health ◽

Stroke Severity ◽

Stroke Patients ◽

Severe Stroke ◽

History Of

ASSOCIATION BETWEEN HISTORY OF HEART DISEASE AND SEVERITY OF ACUTE FIRST-EVER ISCHEMIC STROKEABSTRACTIntroduction: History of heart disease such as atrial fibrillation, angina pectoris, myocardial infarction, heart failure has a role on ischemic stroke severity.Aim: This research aims to find the association between history of heart disease and stroke severity using NIHSS score on acute ischemic stroke patients in Atma Jaya hospital during 2014-2018.Method: This research used cross-sectional method with two-sided fisher’s exact test. With total sampling, samples retrieved from secondary sources in Atma Jaya hospital during 2014-2018 resulting 236 subjects. Stroke severity measured by NIHSS score during admission, categorized with severe stroke (15-42) and non-severe stroke (0-14).Result: There is a significant association between history of AF (p=0.046) on first-ever ischemic stroke severity. Acute first-ever ischemic stroke patients who are >18 years old with history of AF has a tendency of 5,2 times to have severe stroke compared with patients without AF. Other history of heart disease has no significant association towards stroke severity.Discussion: In accordance with previous research, our findings suggest a significant association between history of atrial fibrillation and acute first-ever ischemic stroke severity in which there is a tendency of more severe stroke compared wth patients without AF. Unlike previous findings, this research shows no significant association between history of heart failure and stroke severity due to limited data characteristic of ejection fraction preventing us to include patient with ejection fraction below 30%. This limitation may also allow history of angina pectoris and myocardial infarction to be insignificant.Keywords: Atrial fibrillation, heart failure, ischemic stroke, myocardial infarction, National Institutes of Health Stroke ScaleABSTRAKPendahuluan: Riwayat penyakit jantung seperti atrial fibrilasi, angina pektoris, infark miokardium, gagal jantung memiliki peran terhadap keparahan stroke iskemik.Tujuan: Mengetahui hubungan riwayat penyakit jantung dengan tingkat keparahan stroke berdasarkan skor NIHSS pada pasien stroke iskemik akut di RS Atma Jaya pada tahun 2014-2018.Metode: Penelitian potong lintang terhadap data sekunder pasien stroke iskemik pertama kali yang dirawat di RS Atma Jaya pada tahun 2014-2018. Keparahan stroke diukur berdasarkan National Institutes of Health Stroke Scale (NIHSS) masuk dengan kategori severe stroke (skor 15-42) dan non-severe stroke (0-14). Dilakukan uji Fisher dua sisi untuk menilai hubungan.Hasil: Terdapat 236 subjek dengan mayoritas hubungan riwayat AF (p=0,046) terhadap tingkat keparahan stroke. Pasien berumur >18 tahun yang mengalami stroke iskemik akut pertama kali dengan riwayat AF akan berpeluang 5,2 kali lebih tinggi untuk mengalami severe stroke dibandingkan jika tanpa riwayat AF. Riwayat penyakit jantung lain tidak memiliki hubungan signifikan terhadap tingkat keparahan stroke.Diskusi: Terdapat hubungan yang signifikan antara riwayat AF terhadap tingkat keparahan stroke, terutama pada subjek dengan severe stroke jika dibandingkan pasien tanpa riwayat AF. Tidak ditemukan hubungan signifikan antara penyakit jantung yang lain dikarenakan keterbatasan data penelitian.Kata kunci: Atrial fibrilasi, gagal jantung, infark miokardium, National Institutes of Health Stroke Scale, stroke iskemik

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