title: Clinical characteristics of atrial fibrillation-related cardioembolic stroke in patients aged 80 years or older.
abstract: OBJECTIVE
  Atrial fibrillation (AF)-related cardioembolic stroke is a serious problem in the aging society. The present study examined the clinical characteristics and outcomes of AF-related cardioembolic stroke in patients aged ≥80 years.
  
  
  METHODS
  Between September 2011 and April 2014, consecutive patients with ischemic stroke and AF were retrospectively extracted from the multicenter database. Clinical characteristics were compared between patients aged ≥80 years and <80 years. Multivariate cox proportional hazard models were used to estimate hazard ratios and 95% confidential intervals on 90-day mortality for age of ≥80 years.
  
  
  RESULTS
  A total of 253 patients aged ≥80 years (87 men, 86.4 ± 5.0 years) and 196 patients aged <80 years (134 men, 70.4 ± 7.1 years) were included. Patients aged ≥80 years were more frequently female, and more likely to have higher premorbid modified Rankin Scale score (mRS), lower body mass index, previous history of stroke, prior antiplatelet therapy, congestive heart failure, and persistent AF. Patients aged ≥80 years had higher initial National Institutes of Health Stroke Scale score and were more likely to have occlusion of the cervicocephalic arteries, but less likely to receive thrombolysis. Patients aged ≥80 years had a higher mRS and mortality after 3 months. Age of ≥80 years was a significant predictor of 90-day mortality after adjustment for sex (hazard ratio 2.20, 95% confidential interval 1.25-4.09), but was no longer significant after further adjustment for other clinical characteristics and stroke severity.
  
  
  CONCLUSIONS
  In AF-related cardioembolic stroke, patients aged ≥80 years had different clinical characteristics and poorer outcome compared with patients aged <80 years. Geriatr Gerontol Int 2017; 17: 708-713.
authors.affiliation: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Neurology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.|National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Torii
authors.affiliation: Department of Neurology, Kokura Memorial Hospital, Kitakyushu, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Matsumoto
authors.affiliation: Department of Neurology, Fukuoka City Hospital, Fukuoka, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Yoshimura
authors.affiliation: Department of Neurology, Iizuka Hospital, Iizuka, Japan.
authors.forename: Kei-Ichiro
authors.initials: KI
authors.lastname: Takase
authors.affiliation: Medical Information Center, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Wakata
authors.affiliation: Medical Information Center, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Nakashima
authors.affiliation: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Jun-Ichi
authors.initials: JI
authors.lastname: Kira
authors.affiliation: Department of Neurological Therapeutics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Murai
mesh_terms: D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000175:diagnosis; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D015716:Electrocardiography, Ambulatory; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D020766:Intracranial Embolism / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D018810:Magnetic Resonance Angiography; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D015996:Survival Rate / Q000639:trends; D013614:Tachycardia, Paroxysmal / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator
keywords: aged 80 years and over; atrial fibrillation; outcomes; risk factors; stroke