title: Clinical outcomes of persistent and paroxysmal atrial fibrillation in patients with stroke.
abstract: BACKGROUND
  We compared the clinical outcomes of persistent atrial fibrillation (PeAF) and paroxysmal atrial fibrillation (PAF) in patients with cardioembolic stroke caused by nonvalvular atrial fibrillation (NVAF) because the nature of the fibrillation can cause persistent cerebral infarction.
  
  
  METHODS
  We classified 619 of 964 patients hospitalized with cardioembolic stroke between April 2007 and December 2013 within 24 hours of onset as having PeAF (n = 447) and PAF (n = 172) according to a retrospective analysis of their clinical records, including National Institutes of Health Stroke Scale (NIHSS) scores on admission, clinical outcomes (modified Rankin Scale [mRS] scores) at 90 days after admission, and major cerebral artery occlusion.
  
  
  RESULTS
  The PeAF group was significantly older (P < .001) and had a higher prevalence of hypertension (P = .007), diabetes (P = .039), heart failure (P = .004), previous coronary artery disease (P = .002) and cerebral infarction (P < .001), medication with anticoagulants (P < .001), and elevated blood glucose on admission (P = .002). Neurologic severity assessed by NIHSS scores on admission was significantly worse in the PeAF than in the PAF group (P < .001). Significantly more patients in the PAF group had favorable outcomes (mRS, 0-2) after 90 days (P < .001). The incidence of major cerebral artery occlusion was significantly higher in the PeAF group (P < .001).
  
  
  CONCLUSIONS
  Patients with PeAF and cardioembolic stroke due to NVAF had more severe neurologic deficits on admission, more frequent major arterial occlusion, and poorer outcomes than those with PAF.
authors.affiliation: Department of Neurology, Saitama Medical University International Medical Center, Hidaka, Japan. Electronic address: ideguchi@saitama-med.ac.jp.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Deguchi
authors.affiliation: Department of Neurology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Fukuoka
authors.affiliation: Department of Neurology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Department of Neurology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Maruyama
authors.affiliation: Department of Neurology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Sehara
authors.affiliation: Department of Neurology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kato
authors.affiliation: Department of Neurology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Yohsuke
authors.initials: Y
authors.lastname: Horiuchi
authors.affiliation: Department of Neurology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Yuito
authors.initials: Y
authors.lastname: Nagamine
authors.affiliation: Department of Neurology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Sano
authors.affiliation: Department of Neurology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Tanahashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000453:epidemiology; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology*; D002539:Cerebral Arterial Diseases / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D004185:Disability Evaluation; D004617:Embolism / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008499:Medical Records; D009460:Neurologic Examination; D010343:Patient Admission; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology*; D013997:Time Factors
keywords: Atrial fibrillation; arterial occlusion; cardioembolic stroke; clinical outcome