title: Atrial fibrillation predicts good functional outcome following intravenous tissue plasminogen activator in patients with severe stroke.
abstract: OBJECTIVE
  Atrial fibrillation (AF) is associated with poor outcome after intravenous thrombolysis probably due to greater pretreatment stroke severity. We conducted this retrospective study to determine whether AF is an independent predictor for clinical outcome in patients stratified by initial stroke severity.
  
  
  METHODS
  A total of 143 acute ischemic stroke patients who received intravenous thrombolysis within 3h after onset were enrolled. The patients were categorized according to the baseline stroke severity by National Institute of Health Stroke Scale (NIHSS) score (≤10 vs. >10) and the presence of AF or not. Favorable 90-day outcome was defined as a modified Rankin Scale (mRS) score<2.
  
  
  RESULTS
  Among the 100 patients with severe stroke (NIHSS>10), those with AF (n=52) had a higher proportion of favorable 90-day outcome than those without AF (31% vs. 8%, P=0.005). After adjustment for age, baseline glucose level, and onset to treatment time, the difference remained significant (odds ratio 5.80, 95% confidence interval 1.63-20.68). In patients with mild stroke (NIHSS≤10), no difference in clinical outcome was found between AF (n=20) and non-AF (n=23) groups.
  
  
  CONCLUSIONS
  Presence of AF was associated with favorable 90-day outcome following intravenous thrombolysis in patients with severe stroke at baseline, while the association did not exist in patients with mild stroke.
authors.affiliation: Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan.
authors.forename: Sheng-Feng
authors.initials: SF
authors.lastname: Sung
authors.forename: Yu-Wei
authors.initials: YW
authors.lastname: Chen
authors.forename: Mei-Chiun
authors.initials: MC
authors.lastname: Tseng
authors.forename: Cheung-Ter
authors.initials: CT
authors.lastname: Ong
authors.forename: Huey-Juan
authors.initials: HJ
authors.lastname: Lin
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications* / Q000503:physiopathology; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D013624:Taiwan / Q000453:epidemiology; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D010959:Tissue Plasminogen Activator