Atrial Fibrillation Related and Unrelated Stroke Recurrence Among Ischemic Stroke Patients With Atrial Fibrillation
- 주제(키워드) atrial fibrillation , cardioembolic brain infarction , recurrence , stroke , stroke mechanism
- 주제(기타) Clinical Neurology
- 주제(기타) Neurosciences
- 설명문(일반) [Kim, Bum Joon] Asan Med Ctr, Dept Neurol, Seoul, South Korea; [Hwang, Yang-Ha] Kyungpook Natl Univ Hosp, Dept Neurol, Daegu, South Korea; [Park, Man-Seok; Kim, Joon-Tae; Choi, Kang-Ho] Chonnam Natl Univ Hosp, Dept Neurol, Gwangju, South Korea; [Jung, Jin-Man] Korea Univ, Ansan Hosp, Dept Neurol, Ansan, South Korea; [Yu, Sungwook] Korea Univ, Anam Hosp, Dept Neurol, Seoul, South Korea; [Kim, Chi Kyung; Oh, Kyungmi] Korea Univ, Guro Hosp, Dept Neurol, Seoul, South Korea; [Song, Tae-Jin] Ewha Womans Univ, Seoul Hosp, Dept Neurol, Seoul, South Korea; [Kim, Yong-Jae] Catholic Univ Korea, Dept Neurol, Eunpyeong St Marys Hosp, Seoul, South Korea; [Park, Kwang-Yeol] Chung Ang Univ Hosp, Dept Neurol, Seoul, South Korea; [Kim, Jeong-Min] Seoul Natl Univ Hosp, Dept Neurol, Seoul, South Korea; [Park, Jong-Ho] Hanyang Univ, Coll Med, Myongji Hosp, Dept Neurol, Goyang, South Korea; [Choi, Jay Chol] Jeju Natl Univ Hosp, Dept Neurol, Jeju, South Korea; [Chung, Jong-Won; Bang, Oh Young; Kim, Gyeong-Moon; Seo, Woo-Keun] Samsung Med Ctr, Dept Neurol, Seoul, South Korea; [Heo, Sung Hyuk] Kyung Hee Univ Hosp, Dept Neurol, Seoul, South Korea
- 등재 SCIE, SCOPUS
- OA유형 gold, Green Published
- 발행기관 FRONTIERS MEDIA SA
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000190772
- 본문언어 영어
- Published As https://doi.org/10.3389/fneur.2021.744607
- PubMed https://pubmed.ncbi.nlm.nih.gov/34744981
초록/요약
Background: Ischemic stroke with atrial fibrillation (AF) may recur despite appropriate treatment. It may be AF-related or AF-unrelated. We compared the factors associated with AF-related and AF-unrelated recurrences among ischemic stroke patients with AF.Methods: Patients with ischemic stroke and AF were enrolled from 11 centers in Korea. Ischemic stroke recurrence was classified as AF-related if the lesion pattern was compatible with cardioembolism without significant stenosis or as AF-unrelated if the lesion was more likely due to small vessel disease or arterial stenosis. Factors associated with stroke recurrence (AF-related and AF-unrelated) were investigated.Results: Among the 2,239 patients, 115 (5.1%) experienced recurrence (75 AF-related and 40 AF-unrelated). Factors independently associated with any stroke recurrence included AF diagnosed before stroke, small subcortical infarctions, and small scattered lesions in a single vascular territory. Type of AF was associated with the type of stroke recurrence, with persistent AF being associated with AF-related stroke [hazard ratio (HR) = 2.94, 95% confidence interval (CI) 1.69-5.26; p < 0.001]. By contrast, paroxysmal AF (HR = 3.76, 95% CI 1.56-9.04; p = 0.003), AF diagnosed before stroke (HR = 2.38, 95% CI 1.19-4.55; p = 0.014), small scattered lesions in a single vascular territory (reference: corticosubcortical lesion, HR = 3.19, 95% CI 1.18-8.63; p = 0.022), and the use of antiplatelet agents (HR = 2.11, 95% CI 1.11-4.03; p = 0.024) were independently associated with AF-unrelated stroke.Conclusion: Persistent AF was more associated with AF-related stroke recurrence, whereas paroxysmal AF was more associated with AF-unrelated stroke recurrence. A scattered lesion in a single vascular territory may predict AF-unrelated stroke recurrence.
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