title: Chronic kidney disease is independently associated with acute recurrent cerebral infarct in patients with atrial fibrillation.
abstract: OBJECTIVE
  The present study aimed to determine the frequency and time of recurrent cerebral infarct (RCI) in patients with acute ischemic stroke (AIS) and atrial fibrillation (AF), and to clarify associated factors.
  
  
  METHODS
  We retrospectively assessed and compared the clinical features of 79 consecutive patients (male, n=56; median age, 75y; median baseline NIHSS, 4) who were hospitalized due to AIS accompanied by AF, and who did or did not develop RCI between January 2012 and March 2015.
  
  
  RESULTS
  Direct oral anticoagulants were administered to 59% of the patients after a median of two days from the onset of the index stroke. Stroke recurred in 10 (13%) of the 79 patients about 5days after admission. The proportion of men was lower (30% vs. 77%, P=0.005) and the patients were older (82vs. 75y, P=0.049) in the group with RCI. Chronic kidney disease was significantly more prevalent in the group with RCI (50% vs. 16%, P=0.025) and independently associated with RCI (OR, 6.59; 95%CI, 1.19-36.63; P=0.031).
  
  
  CONCLUSIONS
  We found that RCI frequently develops about 5days after admission in patients with AIS and AF and that chronic kidney disease is independently associated with RCI.
authors.affiliation: Department of Neurology, The Jikei University School of Medicine, Japan. Electronic address: kenichisakuta@yahoo.co.jp.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sakuta
authors.affiliation: Department of Neurology, The Jikei University School of Medicine, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Iguchi
authors.affiliation: Department of Neurology, The Jikei University School of Medicine, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Neurology, The Jikei University School of Medicine, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Sakai
authors.affiliation: Department of Neurology, The Jikei University School of Medicine, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Terasawa
authors.affiliation: Department of Neurology, The Jikei University School of Medicine, Japan.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Mitsumura
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications* / Q000175:diagnosis; D002544:Cerebral Infarction / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology
chemical_list: D000925:Anticoagulants
keywords: Acute ischemic stroke; Atrial fibrillation; Chronic kidney disease; Recurrence