Association between Atrial Fibrillation and Three-Year Mortality in Nondiabetic Patients with Acute First-Ever Ischemic Stroke

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• 作者：Chun-Hsueh Chu ; MD^* ; ^&dagger ; ; Wei-Chieh Weng ; MD^* ; ^&dagger ; ; Feng-Chieh Su ; MD^* ; ^&dagger ; ; Tsung-I Peng ; MD ; PhD^* ; ^&dagger ; ; Yu-Yi Chien ; MD^* ; ^&dagger ; ; Chia-Lun Wu ; MD^* ; ^&dagger ; ; Kuang-Yung Lee ; MD ; PhD^* ; ^&dagger ; ; Yi-Chia Wei ; MD^* ; ^&dagger ; ; Shun-Wen Lin ; MD^* ; ^&dagger ; ; Yi-Jing Yu ; MD^* ; ^&dagger ; ; Wen-Yi Huang ; MD ; PhD^* ; ^&dagger ; ; ^{wenyihuang2003@yahoo.com.tw" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Atrial fibrillation ; diabetes mellitus ; stroke outcome ; mortality ; first-ever ischemic stroke
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：25
• 期：11
• 页码：2660-2667
• 全文大小：236 K

文摘

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.