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Atrial fibrillation predicts for acute ischaemic stroke

Atrial fibrillation predicts for severe stroke and early death in patients with acute ischaemic stroke One of the commonest cardiac arrhythmia is atrial// fibrillation. The risk of thromoembolic complications following atrial fibrillation is nearly seven times more than those with normal sinus rhythm. Previously, studies have shown that AF is present in 15–21% of patients affected by stroke. The principle underlying this fact is that a irregularly beating heart allows blood to pool and clot. When these blood clots enter general circulation they can lodge in blood vessels of the brain and cause stroke.

A retrospective study was undertaken in North Japan to assess whether AF in patients with acute ischemic stroke is associated with severe stroke and early death. 15 831 patients with acute ischemic stroke who were registered over a period of one year in 26 hospitals of the Japan Multicenter Stroke Investigators' Collaboration registry were analyzed. The AF group which included both paroxysmal and persistent AF as identified by ECG consisting of 3335 (21.1%) patients and the non-AF group consisting of 12 496 (78.9%) patients were analyzed for association with severe stroke and early death . The study by means of multivariate logistic regression analyses found that female sex, advanced age, AF, and a history of stroke were independent factors associated with severe stroke while older age, AF, and NIHSS score at admission as independent factors associated with early death.

The study clearly identifies AF as a predictive factor for both severe stroke and early death in acute ischemic stroke. Secondary prevention of embolic events by effective periodic evaluation following atrial fibrillation and appropriate treatment assumes crucial significance.

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