title: Prestroke anticoagulation and paroxysmal type are correlated with favorable outcome in ischemic stroke patients with atrial fibrillation.
abstract: Paroxysmal atrial fibrillation (AF), which often precedes permanent AF, is reported to be a risk factor for milder ischemic stroke. We assessed whether the type of AF and prestroke treatment with an anticoagulant were associated with physical disabilities in patients with AF-related acute ischemic stroke. We identified 162 consecutive acute ischemic stroke patients with AF who were admitted to our hospital over a 3-year period. Disability was measured using the modified Rankin Scale (mRS) at the time of discharge and was categorized according to favorable clinical outcome (mRS score 0-2). Of the 162 patients, 71 (43.8%) had paroxysmal AF and 91 had permanent AF. Fifty-six patients (34.6%) had been treated with a prophylactic anticoagulant. A total of 103 patients (63.6%) had a favorable outcome. Multivariate logistic analysis revealed that paroxysmal AF (odds ratio [OR], 1.58; P = .0187), prestroke anticoagulation treatment (OR, 1.95; P = .0019), and noncardiogenic embolism (OR, 2.20; P = .0073) were independent factors associated with a favorable clinical outcome. Our data indicate that paroxysmal AF and prestroke anticoagulation treatment are independently associated with favorable clinical outcome at the time of hospital discharge in patients with AF.
authors.affiliation: Department of Neurology, Keio University School of Medicine, Tokyo, Japan. hhoshino-keio@umin.ac.jp
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Hoshino
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Itoh
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kimura
authors.forename: Koichi
authors.initials: K
authors.lastname: Miyaki
authors.forename: Norihiro
authors.initials: N
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D002545:Brain Ischemia / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control
chemical_list: D000925:Anticoagulants