Prevalence,risk factors and prognostic value of atrial fibrillation detected after stroke after haemorrhagic versus ischaemic stroke  

作　　者：Jiahuan Guo Zixiao Li Hongqiu Gu Kaixuan Yang Yanfang Liu Jingjing Lu Dandan Wang Jiaokun Jia Jia Zhang Yongjun Wang Xingquan Zhao 

机构地区：[1]Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing,China [2]China National Clinical Research Center for Neurological Diseases,Beijing Tiantan Hospital,Capital Medical University,Beijing,China [3]Research Unit of Artificial Intelligence in Cerebrovascular Disease,Chinese Academy of Medical Sciences,Beijing,China [4]National Center for Healthcare Quality Management in Neurological Diseases,Beijing Tiantan Hospital,Capital Medical University,Beijing,China [5]Chinese Institute for Brain Research,Beijing,China [6]Center of Stroke,Beijing Institute for Brain Disorders,Beijing,China

出　　处：《Stroke & Vascular Neurology》2024年第6期652-659,共8页卒中与血管神经病学(英文)

基　　金：National Key R&D Program of China(2022ZD0118005);Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2019-I2M-5-029);Beijing Municipal Committee of Science and Technology(Z201100005620010);Beijing Hospitals Authority Innovation Studio of Young Staff Funding Support(202112);Ministry of Finance of the People’s Republic of China(issued by Finance and Social Security(2015)Document No.82;(2016)Document No.50;(2017)Document No.72;(2018)Document No.48;(2019)Document No.77;(2020)Document No.75;(2021)Document No.84,Ministry of Finance).

摘　　要：Background and objectives Prior evidence suggests that atrial fibrillation detected after stroke(AFDAS)is distinct from known atrial fibrillation(KAF),with particular clinical characteristics and impacts on outcomes in ischaemic stroke.However,the results remained inconsistent in ischaemic stroke,and the role of AFDAS in haemorrhagic stroke remains unclear.Therefore,we aimed to estimate the prevalence,risk factors and prognostic value of AFDAS in haemorrhagic stroke in comparison with ischaemic stroke.Methods This was a multicentre cohort study.Patients who had an ischaemic and haemorrhagic stroke hospitalised in the Chinese Stroke Center Alliance hospitals were enrolled and classified as AFDAS,KAF or sinus rhythm(SR)based on heart rhythm.Univariate and multivariate logistic regression analyses were used to assess the prevalence,characteristics,risk factors and outcomes of AFDAS,KAF and SR in different stroke subtypes.Results A total of 913163 patients,including 818799 with ischaemic stroke,83450 with intracerebral haemorrhage(ICH)and 10914 with subarachnoid haemorrhage(SAH),were enrolled.AFDAS was the most common in ischaemic stroke.There were differences in the risk factor profile between stroke subtypes;older age is a common independent risk factor shared by ischaemic stroke(OR 1.06,95%CI 1.06 to 1.06),ICH(OR 1.08,95%CI 1.07 to 1.09)and SAH(OR 1.07,95%CI 1.05 to 1.10).Similar to KAF,AFDAS was associated with an increased risk of in-hospital mortality compared with SR in both ischaemic stroke(OR 2.23,95%CI 1.94 to 2.56)and ICH(OR 2.84,95%CI 1.84 to 4.38).Discussion There are differences in the prevalence,characteristics and risk factors for AFDAS and KAF in different stroke subtypes.AFDAS was associated with an increased risk of mortality compared with SR in both ischaemic stroke and ICH.Rhythm monitoring and risk factor modification after both ischaemic and haemorrhagic stroke are essential in clinical practice.More emphasis and appropriate treatment should be given to AFDAS.

关 键 词：haemorrhagic ISCHAEMIC FIBRILLATION 

分 类 号：R743.3[医药卫生—神经病学与精神病学]