Cerebrovascular accidents differ between patients with atrial flutter and patients with atrial fibrillation

被引:1
|
作者
Staszewski, Jacek [1 ]
Bilbin-Bukowska, Anna [1 ]
Szypowski, Wojciech [1 ]
Mejer-Zahorowski, Marcin [1 ]
Stepien, Adam [1 ]
机构
[1] Mil Inst Med, Dept Neurol, 128 Szaserow St, PL-04141 Warsaw, Poland
关键词
stroke; prognosis; atrial flutter; atrial fibrillation; non-cardioembolic stoke; cardioembolic stroke; ISCHEMIC-STROKE; CAUSATIVE CLASSIFICATION; POPULATION; RISK; GUIDELINES; MANAGEMENT; SYSTEM;
D O I
10.5114/aoms.2019.81669
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: Few studies have explored the potential impact of atrial flutter (AFl) on ischaemic stroke (IS) outcome. The aim of the present study was to compare the clinical course of IS in patients with AFl and patients with atrial fibrillation (AF). Material and methods: A retrospective analysis of patients consecutively admitted to a tertiary care centre between 2013 and 2015 due to IS or transient ischaemic attack with permanent AFl or permanent or persistent AF was performed. Results: The study groups consisted of 528 patients, including 490 (92.8%) patients with AF and 38 (7.2%) patients with AFl. The mean age and pre stroke CHA2DS2-VASc scores were similar between the patients with AFl and those with AF. Most IS cases in the AF group were classified as cardioembolic strokes (74.9% vs. 39.5% in AFl, p < 0.01), and lacunar strokes were the most common in the AFl group (47.4% vs. 14.3% in AF, p < 0.01). The multivariable analysis revealed that the presence of AF (OR = 8.6, 95% CI: 1.2-57, p = 0.02), lacunar stroke (OR = 0.1, 95% CI: 0.03-0.31, p < 0.001), baseline Rankin scale score (OR = 16.6, 95% CI: 9.8-28), lack of prestroke therapeutic anticoagulation (OR = 6.1, 95% CI: 1.1-33), diabetes (OR = 2.9, 95% CI: 1.3-6.5, p < 0.01), chronic heart failure (OR = 14.2, 95% CI: 5.8-34, p < 0.001), and current smoking (OR = 0.92, 95% CI: 0.39-0.99, p < 0.01) were significantly associated with the stroke outcome. Conclusions: Disabling or fatal IS was observed less often in patients with AFl than in patients with AF. This finding can possibly be explained by the more frequent occurrence of lacunar strokes in the AFl group compared with that in the AF group.
引用
收藏
页码:1590 / 1598
页数:9
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