Clinical Characteristics of Transient Ischemic Attack Patients with Atrial Fibrillation: Analyses of a Multicenter Retrospective Study.
BACKGROUND
Atrial fibrillation (AF) is an important risk factor for transient ischemic attack (TIA). However, little is known about the characteristics of TIA patients with AF. This study investigated the characteristics of such patients, using data from a retrospective, observational, multicenter study.


METHODS
TIA patients admitted to 13 stroke centers in Japan within 7 days of onset between January 2008 and December 2009 were included. The present analyses compared baseline characteristics, clinical symptoms, findings from diffusion-weighted imaging (DWI), and clinical outcomes between patients with and without AF (AF and non-AF groups).


RESULTS
A total of 464 patients (292 men; mean age 68.5 ± 13.2 years) were registered. Of these, 79 patients (17%) had AF. Patients in the AF group were older (73.9 ± 9.1 vs. 67.4 ± 13.6 years, p < 0.001) and more likely to show disturbance of consciousness (13 vs. 6%, p = 0.046) and aphasia (9 vs. 3%, p = 0.007) than patients in the non-AF group. Although no difference in the overall DWI-positive rate was seen between the groups (28 vs. 20%, p = 0.102), a single lesion (23 vs. 10%, p < 0.001), a lesion ≥15 mm (11 vs. 4%, p = 0.006), and a single lesion ≥15 mm (11 vs. 2%, p < 0.001) on DWI were more frequent in the AF group. Multivariate logistic regression analysis identified increased age [odds ratio (OR) 1.04; 95% confidence interval (CI) 1.02-1.07] and DWI single lesion ≥15 mm (OR 5.67; 95% CI 1.92-16.7) as independently associated with the presence of AF.


CONCLUSIONS
In this study, 17% of our TIA patients had AF. We found an association between the acute ischemic lesion pattern on DWI of a single lesion ≥15 mm and AF in TIA patients. These results might lead to a better diagnosis of TIA patients with AF.
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Tokyo, Japan.
Yuka
Y
Hama
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Tokyo, Japan.
Toshiyuki
T
Uehara
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Tokyo, Japan.
Tomoyuki
T
Ohara
Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Tokyo, Japan.
Kazumi
K
Kimura
Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Tokyo, Japan.
Yasushi
Y
Okada
Department of Neurology, Nagoya Daini Red Cross Hospital, Nagoya, Tokyo, Japan.
Yasuhiro
Y
Hasegawa
Department of Neurology and Cerebrovascular Medicine, Saitama Medical University, Saitama International Medical Center, Hidaka, Tokyo, Japan.
Norio
N
Tanahashi
Department of Stroke Science, Research Institute for Brain and Blood Vessels Akita, Akita, Tokyo, Japan.
Akifumi
A
Suzuki
Department of Neurology, Tokai University, Isehara, Tokyo, Japan.
Shigeharu
S
Takagi
Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Tokyo, Japan.
Jyoji
J
Nakagawara
Department of Neurology, Ebara Hospital, Tokyo, Japan.
Kazumasa
K
Arii
Department of Neurosurgery, Tokushima University, Tokushima, Japan.
Shinji
S
Nagahiro
Department of Neurosurgery, Iwate Medical University, Morioka, Japan.
Kuniaki
K
Ogasawara
Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan.
Takehiko
T
Nagao
Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan.
Shinichiro
S
Uchiyama
Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan.
Masayasu
M
Matsumoto
Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Tokyo, Japan.
Koji
K
Iihara
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Tokyo, Japan.
Kazunori
K
Toyoda
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Tokyo, Japan.
Kazuo
K
Minematsu
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000453:epidemiology / Q000473:pathology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
Atrial fibrillation; Diffusion-weighted imaging; Transient ischemic attack