title: Association between Atrial Fibrillation and Three-Year Mortality in Nondiabetic Patients with Acute First-Ever Ischemic Stroke.
abstract: BACKGROUND
  Diabetes mellitus (DM) is a risk factor for atrial fibrillation (AF) and is known to be an important risk factor for death from stroke. The influence of AF on long-term outcomes in patients with ischemic stroke remains controversial. To clarify the exact influence of AF on stroke outcome and exclude the effect from DM, we investigated the influence of AF on the 3-year outcomes of nondiabetic patients with acute first-ever ischemic stroke.
  
  
  METHODS
  Five-hundred seventy-four nondiabetic patients with acute first-ever ischemic stroke were enrolled and had been followed for 3 years. Patients were divided into 2 groups according to whether AF was diagnosed or not. Clinical presentations, risk factors for stroke, laboratory data, comorbidities, and outcomes were recorded.
  
  
  RESULTS
  A total of 107 patients (18.6%) had AF. The age was significantly older in patients with AF. Total anterior circulation syndrome occurred more frequently among patients with AF (P < .001). The mean length of stay in the acute ward was significantly higher in patients with AF (P < .001). Furthermore, dependent functional status following discharge was higher in patients with AF (P < .001). Multivariate Cox regression revealed that AF is a significant predictor of 3-year all-cause mortality (hazard ratio = 1.98, 95% confidence interval = 1.07-3.67, P = .022).
  
  
  CONCLUSIONS
  AF is associated with increased risk of 3-year mortality in nondiabetic patients with acute first-ever ischemic stroke. Careful cardiac evaluation and treatment are essential in patients with AF and stroke.
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Chun-Hsueh
authors.initials: CH
authors.lastname: Chu
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Wei-Chieh
authors.initials: WC
authors.lastname: Weng
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Feng-Chieh
authors.initials: FC
authors.lastname: Su
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Tsung-I
authors.initials: TI
authors.lastname: Peng
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Yu-Yi
authors.initials: YY
authors.lastname: Chien
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Chia-Lun
authors.initials: CL
authors.lastname: Wu
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Kuang-Yung
authors.initials: KY
authors.lastname: Lee
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Yi-Chia
authors.initials: YC
authors.lastname: Wei
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Shun-Wen
authors.initials: SW
authors.lastname: Lin
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Yi-Jing
authors.initials: YJ
authors.lastname: Yu
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan. Electronic address: wenyihuang2003@yahoo.com.tw.
authors.forename: Wen-Yi
authors.initials: WY
authors.lastname: Huang
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D002545:Brain Ischemia / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors
keywords: Atrial fibrillation; diabetes mellitus; first-ever ischemic stroke; mortality; stroke outcome