Contribution of Atrial Fibrillation to Incidence and Outcome of Ischemic Stroke: Results From a Population-Based Study
Abstract
Background and Purpose— Atrial fibrillation (AF) is a major risk factor for ischemic stroke and its prevalence increases steeply with age. Population-based data on its influence on stroke outcome are scarce. Methods— We evaluated the prevalence of AF and its influence on prognosis in patients with a first-ever ischemic stroke from a population-based registry. Results— The presence of AF at stroke onset and during the acute phase was confirmed by a standard electrocardiogram in 869 (24.6%) of 3530 patients with ischemic stroke. With respect to patients without the arrhythmia, those with AF were more frequently women, aged 80 years and older, with coronary heart disease and peripheral arterial disease. The presence of AF was associated with high 30-day (32.5%; 95% CI, 29.3 to 35.6) and 1-year case-fatality rates (49.5%; 95% CI, 46.2 to 52.8), with a higher stroke recurrence rate within the first year of follow-up (6.6% versus 4.4%; P =0.046) and with the worst survival after an average follow-up of 45.2 months ( P <0.0001). At the multivariate Cox regression analysis, AF was an independent predictor of 30-day and 1-year mortality. Approximately 17% of all deaths were attributable to the presence of AF. Conclusions— We found a high prevalence of AF in patients with a first-ever ischemic stroke, especially among elderly women. The overall contribution of AF to stroke mortality was relevant, suggesting that together with new strategies to prevent the development of the arrhythmia more appropriate treatments are needed, mostly in elderly women.
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Postdischarge AECG recording after cryptogenic stroke has particular utility, although AF detection is sensitive to patient selection, definition of AF, and duration of monitoring.
“Postdischarge AECG recording after cryptogenic stroke has particular utility (Marini et al., 2005) although AF detection is sensitive to the patient selection process, the definition of AF, and the duration of monitoring.”
From 2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry (2017) · cites this paper as Marini et al., 2005
The Subjects and Methods (p. 2) describe standard 12-lead ECG assessment at stroke onset and during the acute phase, not postdischarge ambulatory ECG recording after cryptogenic stroke. A 7-day ambulatory ECG study appears in the References (p. 5), but this paper does not report or discuss the claimed particular utility. Searched for postdischarge monitoring and cryptogenic stroke. (LLM, conf=0.76)
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- Authors
- Marini, C., De Santis, F., Sacco, S., Russo, T., Olivieri, L., Totaro, R., & Carolei, A.
- Affiliations
- University of L'Aquila (IT)
- From Clinica Neurologica, Università degli Studi di L’Aquila, L’Aquila, Italy.
- Venue
- Stroke
- Published
- 2005-06
- Volume
- 36
- Issue
- 6
- Pages
- 1115-1119
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2055586130
- Cited by
- 949
- References
- 28
- Citations by year
- 2026: 32 · 2025: 41 · 2024: 49 · 2023: 42 · 2022: 62 · 2021: 52 · 2020: 47 · 2019: 61 · 2018: 60 · 2017: 59 · 2016: 49 · 2015: 66 · 2014: 63 · 2013: 68 · 2012: 59
- FWCI
- 9.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università degli Studi dell Aquila (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
- Keywords
- atrial fibrillation, ischemic stroke, stroke mortality, case fatality, stroke recurrence, stroke prognosis, older women, atrial fibrillation prevalence, cardiovascular risk factors, coronary artery disease, peripheral arterial disease
- MeSH terms
- Adult, Aged, Aged, 80 and over, Atrial Fibrillation, Electrocardiography, Female, Humans, Ischemia, Male, Middle Aged, Prognosis, Recurrence, Registries, Regression Analysis, Risk Factors, Time Factors, Incidence, Proportional Hazards Models, Treatment Outcome, Stroke
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