scholarly journals Relationship between Atrial Fibrillation as a Risk Factor and the Outcome of Ischemic Stroke

2018 ◽  
Vol 49 (1) ◽  
pp. 6-12
Author(s):  
Siniša Miljković ◽  
◽  
Andrej Blagojević ◽  
Tamara Petrušić ◽  
◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Ischemic Stroke

Anticoagulant therapy in practice

2012 ◽  
Vol 153 (19) ◽  
pp. 732-736
Author(s):  
Gergely Hofgárt ◽  
Csilla Vér ◽  
László Csiba
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Acute Stroke ◽  
Anticoagulant Therapy ◽  
Oral Anticoagulants ◽  
Health Science ◽  
Science Centre ◽  
Improper Use ◽  
Current Guidelines

Atrial fibrillation is a risk factor for ischemic stroke. To prevent stroke oral anticoagulants can be administered. Old and new types of anticoagulants are available. Nowadays, old type, acenocumarol based anticoagulants are used preferentially in Hungary. Aim: The advantages and the disadvantages of anticoagulants are well known, but anticoagulants are underused in many cases. Method: The authors retrospectively examined how frequent atrial fibrillation was and whether the usage of anticoagulants in practice was in accordance with current guidelines among acute stroke cases admitted to the Department of Neurology, Medical and Health Science Centre of Debrecen University in 2009. Results: Of the 461 acute stroke cases, 96 patients had known and 22 patients had newly discovered atrial fibrillation. Half of the patients did not receive proper anticoagulation. Only 8.4% of them had their INR levels within the therapeutic range. Conclusions: The findings are similar to those reported in other studies. Many factors may contribute to the high proportion of improper use of anticoagulants, and further investigations are needed to determine these factors. In any case, elimination of these factors leading to a failure of anticoagulation may decrease the incidence of stroke. Orv. Hetil., 2012, 153, 732–736.

P4776Age-dependent anti-thrombotic therapy for atrial fibrillation patients with intermediate risk (CHA2DS2-VASc Score of 1 or 2) of ischemic stroke

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K M Lee ◽  
M H Kim ◽  
S Y Choi ◽  
S J Kim ◽  
S W Kim ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Oral Anticoagulants ◽  
Intermediate Risk ◽  
Risk Criterion ◽  
Korean National Health Insurance ◽  
Effect Of Age ◽  
Annual Risk

Abstract Background Although older age is one of the most important risk factor for stroke in atrial fibrillation (AF), it is unclear whether oral anticoagulants are beneficial for AF patients with intermediate CHA2DS2-VASc score (1 for male or 2 for female) according to age threshold. We sought to investigate the effect of age-dependent antithrombotic therapy for ischemic stroke in Korean intermediate risk AF patients. Methods We enrolled 29,592 patients (males with CHA2DS2-VASc score of 1 and females with CHA2DS2-VASc score of 2) using the Korean National Health Insurance Service database. The clinical endpoint was the occurrence of ischemic stroke. The propensity score matching method was used to balance covariates across treated and untreated patients. Results Treated male AF patients were 6,570 (67.1%) with age <55 years, 7,115 (70.9%) with 55–64 years and 6,470 (68.3%) with 65–74 years in each age risk criterion. Also, treated female AF patients were 3,156 (71.3%) with age <55 years, 2,838 (71.0%) with 55–64 years and 3,440 (72.6%) with 65–74 years in each age risk criterion. Among male and female patients (age <55 years and 55–64 years) with 1 risk factor, an annual ischemic stroke rate was not significantly different between treated and untreated patients at full follow-up. However, treated AF patients who are in age 65–74 year without other risk factor had a much lower annual risk of ischemic stroke [(1.05%/year (male) and 1.04%/year (female)] compared with untreated patients [(1.77%/year (male) (p<0.026) and 1.86%/year (female) (p<0.041). Conclusions Age is an important predictor in determining the risk of ischemic stroke in AF patients with intermediate CHA2DS2-VASc scores (1 for male or 2 for female). We suggest that the benefit of anti-thrombotic therapy for intermediate risk AF patients depends on age threshold.

scholarly journals Study of Outcome of Ischemic Stroke Patient With Atrial Fibrillation

2018 ◽  
Vol 28 (2) ◽  
pp. 1-6
Author(s):  
Achinta Kumar Mallick ◽  
Md Kafil Uddin ◽  
Md Ahmed Ali ◽  
Pijus Kumar Kundu ◽  
Sheikh Mohammad Emdadul Haque ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Linear Regression Analysis ◽  
Clinical Deterioration ◽  
Stroke Recurrence ◽  
Stroke Severity ◽  
Multivariate Linear Regression Analysis ◽  
Stroke Patients

Atrial fibrillation (AF) is a common arrhythmia and a major risk factor for ischemic stroke, especially in the elderly. Patients with nonvalvular AF have a 5-fold excess risk of stroke. However, population-based data are scarce in patients who have experienced a first-ever ischemic stroke in the presence of AF regarding long-term risk of stroke recurrence and case-fatality rate. Aim of the study is to find out the outcome of ischemic stroke patients with Atrial Fibrillation. It was a descriptive type cross sectional study where 125 diagnosed cases of ischemic stroke were included. Presence of atrial fibrillation was detected by electrocardiogram. They were divided into two groups – those with atrial fibrillation and those without. Comparison was done between the two group in term of recurrence, mortality and clinical improvement. Atrial fibrillation was present in 22 (17.6%) of 125 patients with ischemic stroke. Those with AF were more frequently male, aged 45 years and older. The presence of AF was associated with high 3 months (Χ2 =4.562, df = 1, p<0.05) and 6 months mortality (Χ2 =7.868, df = 1, p<0.05), with a higher stroke recurrence rate within the first 6 months follow-up (22.7% versus 7.8% (<0.05)). At 3 months follow up clinical deterioration was noted in 9.1% patient with atrial fibrillation compared to 2.9% patients who had no arrhythmia(p<0.01) and at 6 months follow up clinical deterioration was noted in 18.2% patient with atrial fibrillation compared to 4.9% patients who had no arrhythmia(p<0.01). Ischemic stroke patients with atrial fibrillation had significant mortality within the study period compared to those without atrial fibrillation. Significant deterioration in clinical outcome was noted in atrial fibrillation group after six months. Recurrence was more in ischemic stroke patients with atrial fibrillation. Multivariate linear regression analysis shows atrial fibrillation as well as CKD, Diabetes mellitus and smoking as independent risk factor for recurrence. In conclusion, patients who had an ischemic stroke with accompanying atrial fibrillation had higher mortality, grave stroke severity, more recurrences and poorer functional status than those without atrial fibrillation.TAJ 2015; 28(2): 1-6

scholarly journals Gender Differences in the Impact of New-Onset Atrial Fibrillation on Long-Term Risk of Ischemic Stroke after Acute Myocardial Infarction

2021 ◽  
Vol 10 (21) ◽  
pp. 5141
Author(s):  
Jeong-Eun Yi ◽  
Suk-Min Seo ◽  
Sungmin Lim ◽  
Eun-Ho Choo ◽  
Ik-Jun Choi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Coronary Syndrome ◽  
The Impact ◽  
Onset Atrial Fibrillation ◽  
New Onset

Background: Atrial fibrillation (AF) has been identified as a major risk factor for mortality after acute coronary syndrome (ACS). However, the long-term risk of ischemic stroke associated with new-onset atrial fibrillation (NOAF) in ACS remains controversial, and its gender-specific association is unknown. Methods: We analyzed the data of 10,137 ACS survivors included in a multicenter, prospective registry for Korean patients with acute myocardial infarction (AMI) between January 2004 and August 2014. Subjects were categorized into three groups (non-AF vs. NOAF vs. previous AF) based on medical history and electrocardiographic evidence of AF, either at admission or during hospitalization. Results: Among the total study population (72.3% men), 370 patients (3.6%) had NOAF and 130 (1.3%) had previous AF. During a median follow-up of 61 months (interquartile range, 38.8 to 89.3 months), 245 (2.4%) patients (218 (2.3%) non-AF vs. 15 (4.1%) NOAF vs. 12 (9.2%) previous AF, p < 0.001) experienced ischemic stroke. After adjustment for confounding variables, both NOAF (adjusted hazard ratio (HR) 1.87, 95% confidence interval (CI) 1.09–3.24, p = 0.024) and previous AF (adjusted HR 4.00, 95% CI 2.03–7.87, p < 0.001), along with older age, diabetes, current smoker, and previous stroke were independent risk factors of ischemic stroke. In the gender-stratified analysis, men with previous AF but not NOAF had a significantly higher risk of ischemic stroke (adjusted HR 4.14, 95% CI 1.79–9.55, p = 0.001) than those without AF. In women, NOAF (adjusted HR 2.54, 95% CI 1.21–5.35, p = 0.014) as well as previous AF (adjusted HR 3.72, 95% CI 1.16–11.96, p = 0.028) was a strong predictor of ischemic stroke, and the predictive value was comparable to that of previous AF among patients with a CHA2DS2-VASc score ≥ 2. Conclusions: Both NOAF and previous AF were associated with ischemic stroke after AMI, but the impact of NOAF as a risk factor of ischemic stroke was significant only in women.

scholarly journals TOAST Subtypes of Ischemic Stroke and Its Risk Factors: A Hospital-Based Study at Cipto Mangunkusumo Hospital, Indonesia

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Salim Harris ◽  
Saleha Sungkar ◽  
Al Rasyid ◽  
Mohammad Kurniawan ◽  
Taufik Mesiano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Significant Risk ◽  
Large Artery ◽  
Stroke Risk Factor ◽  
Stroke Subtypes ◽  
Undetermined Etiology ◽  
Toast Classification

Background and Purpose. Stroke is a leading cause of death and disability, with ischemic stroke as the highest prevalent cases in Indonesia. Ischemic stroke can be classified further into five subtypes according to TOAST classification. Numerous studies have revealed that stroke risk factor has variable correlation with different stroke subtype. Currently, there is no data regarding this phenomenon in Indonesia. The aim of study is to identify characteristic of ischemic stroke subtypes and the risk factors in TOAST classification. Methods. A retrospective, cross-sectional study of patients diagnosed with ischemic stroke at Cipto Mangunkusumo Hospital from January till December 2016. Demographic data, ischemic stroke subtypes, risk factors, and other relevant data were documented. Bivariate and multivariate analysis was done using SPSS 23. Results. 235 recorded data patients were included. Large artery atherosclerosis (LAA) was the most prevalent stroke subtypes at 59,6%, followed with small vessel disease (SVD) at 26,7%, undetermined etiology at 9,8%, cardioembolism (CE) at 2,1%, and other determined etiology at 0,9%. Hypertension was the most common vascular risk factor. However, it was only significant in SVD (p=0,023) and undetermined etiology subtypes (p<0,001). Significant risk factor in LAA was diabetes (55%; p=0,016) while in CE subtypes was atrial fibrillation (60%;p<0,001). In multivariate analyses, hypertension (OR 3; 95% CI 1,12-8,05) was the only variable that was related to SVD while in CE it was atrial fibrillation (OR 113,5; 95% CI 13,6-946,5). Conclusion. LAA was the most common stroke ischemic subtypes. Associated risk factor in LAA was diabetes while in SVD and undetermined etiology subtypes it was hypertension. Atrial fibrillation was associated with cardioembolism.

Atrial fibrillation as a risk factor for ischemic stroke

2015 ◽  
Vol 17 (9) ◽  
pp. 16-20
Author(s):  
M.Yu. Gilyarov ◽  
◽  
E.V. Konstantinova ◽  
◽  
◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Ischemic Stroke

P3755Left atrial enlargement as an independent risk factor for ischemic stroke in Japanese atrial fibrillation patients: pooled analysis of five major Japanese atrial fibrillation registries

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Akao ◽  
H Ogawa ◽  
S Suzuki ◽  
T Yamashita ◽  
E Kodani ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Oral Anticoagulant ◽  
Left Atrial ◽  
Large Scale ◽  
Chads2 Score ◽  
Left Atrial Diameter ◽  
Atrial Enlargement ◽  
The Impact

Abstract Background Atrial fibrillation (AF) increases the risk of ischemic stroke. It remains unknown whether left atrial diameter determined by routine trans-thoracic echocardiography is a risk factor for ischemic stroke in non-valvular AF (NVAF) patients. Purpose The aim of this study is to investigate the impact of left atrial enlargement (LAE) on the incidence of ischemic stroke in a large-scale cohort of Japanese NVAF patients. Methods We combined the data of 5 major AF registries in Japan, J-RHYTHM Registry, Fushimi AF Registry, Shinken Database, Keio interhospital Cardiovascular Studies, and Hokuriku AF Registry. After excluding patients without echocardiographic data, 7,672 NVAF patients were analyzed in the present study (mean age, 69.3±12.3 years; mean CHADS2 score, 1.6±1.3). We compared clinical characteristics and the incidence of ischemic stroke between NVAF patients with LAE (left atrial diameter >45 mm; LAE group) and those without (non-LAE group). Results The mean left atrial diameter was 43.1±8.6 mm, and the LAE group accounted for 40.0% (n=3,066) of the entire cohort. Compared with non-LAE group (60.0%, n=4,606), the LAE group was older (LAE vs. non-LAE; 70.3±12.0 vs. 68.0±12.5, p<0.01), more often non-paroxysmal type (73.7% vs. 32.1%, p<0.01), had higher CHADS2 (1.86±1.34 vs. 1.46±1.29, p<0.01) and CHA2DS2-VASc (3.02±1.83 vs. 2.53±1.78, p<0.01) scores, and more frequently received oral anticoagulant (72.9% vs. 55.0%, p<0.01). During the median follow-up period of 774.5 days (interquartile range: 567–1466 days), ischemic stroke occurred in 241 patients (131 vs. 110 patients; 1.52 vs. 0.82 per 100 person-years). In Kaplan Meier analysis, LAE was associated with a higher incidence of ischemic stroke (unadjusted hazard ratio (HR): 1.83, 95% confidence interval (CI): 1.42–2.36; log rank p<0.01) (Figure). LAE was independently associated with increased risk of ischemic stroke (adjusted HR: 1.63, 95% CI: 1.25–2.11; p<0.01) after adjustment by the components of CHADS2 score and the use of oral anticoagulant, on multivariate Cox proportional hazard analysis. Conclusion In this large-scale cohort of Japanese patients with AF, LAE was an independent predictor of ischemic stroke, suggesting that this simple echocardiographic parameter could refine thromboembolic risk stratification of NVAF patients. Acknowledgement/Funding Japan Agency for Medical Research and Development, AMED

scholarly journals 2162Coronary artery disease is an independent risk factor for ischemic stroke among patients with atrial fibrillation

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
K Steensig ◽  
K K W Olesen ◽  
T Thim ◽  
J C Nielsen ◽  
M Madsen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Independent Risk Factor ◽  
Artery Disease

scholarly journals A hospital-based study of post-stroke aphasia: frequency, risk factors, and topographic representation

2019 ◽  
Vol 56 (1) ◽  
Author(s):  
Eman M. Khedr ◽  
Mohamed A. Abbass ◽  
Radwa K. Soliman ◽  
Ahmed F. Zaki ◽  
Aymen Gamea ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Parietal Lobe ◽  
Inferior Parietal Lobe ◽  
Post Stroke ◽  
Motor Aphasia ◽  
Sensory Aphasia ◽  
High Risk Factor

Abstract Background and objective The crude prevalence rate of stroke in Qena, Egypt, is high (922/100,000). For the first time, we estimate the frequency of aphasia following the first-ever ischemic stroke and its relationship to the site of lesion in Arabic-speaking countries. Methods The study was conducted on 180 acute or subacute ischemic stroke patients. Aphasia was diagnosed with the short form of the Boston Diagnostic Aphasia Examination after establishment of the cases (at least 10 days of stroke onset). Computed tomography and/or magnetic resonance imaging were performed for topographic localization of stroke, and routine laboratory investigations were done to evaluate the possible stroke risk factors. Results The frequency of post-stroke aphasia was recorded in 20%, and atrial fibrillation (AF) represents a high-risk factor for ischemic stroke with aphasia. The following categories were observed: global aphasia in 50%, motor aphasia in 27.7%, sensory aphasia in 11.1%, nominal aphasia in 2.8%, and conductive aphasia in 8.3%. Global aphasia was mainly associated with complete middle cerebral artery (MCA) territories infarction. Motor aphasia was associated mainly with frontal or frontoparietal operculum lesions as well as basal ganglionic lesions. Sensory aphasia was associated with temporal lobe lesions, inferior parietal lobe, and basal ganglia. Conductive aphasia showed lesions in the deep white matter of the frontal and parietal lobes. Anomic aphasia was associated with inferior parietal lobe lesion. Conclusion Our data are consistent with other reports as regards the frequency and risk factors of post-stroke aphasia. Atrial fibrillation represents a high-risk factor for ischemic strokes with aphasia. Global and motor aphasia are the major subtypes. The lesion locations are predictive of aphasia subtypes.

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