The Impact of Atrial Fibrillation on the Outcome of Ischemic Stroke Treated With Thrombolysis or Endovascular Therapy

Abstract

Background: The purpose of this study was to assess the impact of atrial fibrillation (AF) on stroke outcome in acute ischemic stroke (AIS) treated with thrombolysis or endovascular therapy (EVT).

Method: Consecutive AIS treated at five stroke centers over 15 years was evaluated. Using multiple logistic regressions, we compared adjusted odds ratio (OR) with 95% confidence interval (CI) of symptomatic intracranial hemorrhage (sICH), thrombolysis in cerebral infarction (TICI), poor discharge disposition (hospice/skilled nursing facility), in-hospital mortality, and disability (modified Rankin Scale (mRS)) and death at 90 days. Patients were classified according to AF and treatment plans, including tissue plasminogen activator (tPA) or EVT.

Results: We identified 720 patients treated in the study period (196 +AF, aged 78.2 ± 12.5 years and 524 -AF, aged 66.9 ± 15.2 years). In adjusted logistic regression, there was no difference in the rate of sICH (OR: 1.18, 95% CI: 0.44 - 3.17), TICI (OR: 1.19, 95% CI: 0.29 - 4.84), poor discharge disposition to hospice/skilled nursing facility (OR: 0.96, 95% CI: 0.56 - 1.63) or in-hospital mortality (OR: 0.95, 95% CI: 0.46 - 1.97). There was no significant difference in a 90-day mRS in those with and without AF. Likewise, there were no between group differences in sICH, discharge outcome, or 90-day mRS in the six groups based on the presence of AF and treatment plans (tPA, EVT, or both).

Conclusions: AF did not significantly impact sICH, discharge outcome, or 90-day mRS in AIS patients treated with thrombolysis, EVT, or both. Age and baseline National Institutes of Health Stroke Scale (NIHSS) were significant predictors of outcome in this sample.

J Neurol Res. 2022;12(3):121-127
doi: https://doi.org/10.14740/jnr738