Strokes in paroxysmal atrial fibrillation have more favorable outcome than in permanent atrial fibrillation.
OBJECTIVE
Our aim was to compare the course of IS due to ptAF and pxAF.


METHODS
A prospective, single-center study was conducted in patients with AF and acute IS with 6-month follow-up.


RESULTS
We included 178 patients: 70 (39%) with pxAF and 108 (61%) with ptAF. Compared with patients with ptAF, patients with pxAF more often presented with subcortical, mainly lacunar strokes (21% vs 8%, P = 0.01) and were less frequently dependent at discharge (16% vs 42%, P < 0.001) and after 6 months (16% vs 20%, P < 0.001). Strokes in patients with pxAF were more frequently categorized as non-cardioembolic (35% vs 18%, P = 0.01). In the multivariate analysis, after adjustment for confounding factors (diabetes, chronic heart failure, high risk of thromboembolism and lack of prestroke anticoagulation), ptAF was an important risk factor for unfavorable short-term (OR 5.4; P < 0.01) and long-term outcomes (OR 2.6, P = 0.01) of IS. In all patients with AF, the occurrence of non-cardioembolic stroke was related to a reduced risk of dependence or death in short-term outcome (OR 0.4, P = 0.04) and marginally influenced long-term outcome (OR 0.49, P = 0.09).


CONCLUSIONS
The present study suggests that, compared with patients with ptAF, ISs in patients with pxAF have better outcomes.
Staszewski
J
J
Department of Neurology, Military Medical Institute, Warsaw, Poland. staszej@amwaw.edu.pl
Brodacki
B
B
Tomczykiewicz
K
K
Kotowicz
J
J
Stepien
A
A
D000208:Acute Disease / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D020520:Brain Infarction / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D002908:Chronic Disease / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods; D011044:Poland / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D015996:Survival Rate; D016896:Treatment Outcome