What is the prevalence of atrial fibrillation and its associated factors in patients with ischemic stroke?
1,500 ischemic stroke patients, median age 73 years, 44.1% female, from a single center in the Netherlands (January 2019 to October 2024).
Prevalence of atrial fibrillation and associated factors
Nearly 30% of ischemic stroke patients have atrial fibrillation, with previous stroke and left atrial remodeling being strong predictors, highlighting the need for targeted screening.
Abstract Background and aims Atrial fibrillation (AF) is a common cause of ischemic stroke and a major global health burden. AF can be difficult to detect due to its often paroxysmal and asymptomatic occurrence. However, its detection is essential due to implications for anticoagulation therapy. The aim of this study was to determine the prevalence and factors associated with AF among ischemic stroke patients. Methods In this retrospective cohort study, all ischemic stroke patients from the Radboudumc (Nijmegen, the Netherlands) from January 2019 until October 2024 were included. Subsequently, descriptive statistics, multivariable logistic regression and generative topographic mapping (GTM) were applied. Results Of 1500 patients (median age 73 years IQR 63-80 and 44.1% female), 29.4% had AF, of which 18.7% previously known and 10.7% newly identified (Table 1). The most significant factors associated with AF were previous ischemic stroke, increased left atrial volume and increased peak E wave velocity (Figure 1). GTM showed the phenotype with older age, more severe infarcts, previous ischemic stroke, hypertension, myocardial infarction, heart valve abnormalities, heart failure, impaired kidney function, high premature ventricular complex burden and severe left atrial remodeling to be most associated with AF (Table 2). Conclusions The prevalence of AF and stroke severity among AF-patients in this study highlights the relevance of optimizing monitoring strategies. Previous ischemic stroke, high cardiac burden and left atrial remodeling signs were most strongly associated with AF. These findings suggest potential areas for target screening, however prospective studies are essential to further investigate the causal relationship. Conflict of interest All authors: nothing to disclose. Table 1 - belongs to Results Figure 1 - belongs to Conclusions Table 2 - belongs to Conclusions
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Evi van Kempen
Wouter Elzinga
Tim ten Cate
European Stroke Journal
Radboud University Nijmegen
Radboud University Medical Center
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Kempen et al. (Fri,) studied this question.
www.synapsesocial.com/papers/69fd7e90bfa21ec5bbf06dda — DOI: https://doi.org/10.1093/esj/aakag023.1605