Clinical features of transient ischemic attack associated with atrial fibrillation: analysis of 1084 TIA patients.
Approximately 10% of patients with transient ischemic attack (TIA) associate with atrial fibrillation (AF). The present study aimed to clarify clinical features of TIA patients with AF. The study group comprised 1084 patients with TIA who were registered in the Japan Multicenter Stroke Investigators' Collaboration (J-MUSIC) registry between May 1999 to April 2000. Clinical characteristics and symptoms during ictus were analyzed to investigate factors associated with AF using multivariate logistic analysis. Subjects were categorized into an AF group (n = 186, 17%; median age, 72 years) and a non-AF group (n = 898, 83%; median age, 69 years). Multivariate logistic regression analysis identified 4 variables as independent factors associated with AF: (1) age > 59 years (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.4-3.8), (2) consciousness disturbance (OR, 1.6; 95% CI, 1.1-2.4), (3) speech disturbance (OR, 1.7; 95% CI, 1.2-2.4), and (4) gait disturbance (OR, 1.6; 95% CI, 1.1-2.2). Using a simple index of 1 point for each factor of age > or = 60 years, consciousness disturbance, speech disturbance, and gait disturbance, 4.8% of patients without these factors displayed AF, compared with 12.4% of patients with 1 factor, 20.6% with 2 factors, and 29.7% with 3 or 4 risk factors. In all TIA patients, the frequency of association with AF was 17%. TIA patients with AF are likely to be older (> or = 60 years) and to have more frequent disturbance of consciousness, speech, or gait during the attack compared with those without AF. The pathogenesis of TIA may differ between TIA patients with and without AF.
Inoue
Takeshi
T
Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, Kawasaki Medical School, Okayama, Japan. inouet@med.kawasaki-m.ac.jp
Kimura
Kazumi
K
Minematsu
Kazuo
K
Yamaguchi
Takenori
T