[Atrial fibrillation and stroke].

BACKGROUND

Atrial fibrillation (AF) is a known risk factor for stroke. Furthermore, it has been suggested that the severity of the stroke is increased in these patients. We studied the clinical characteristics, radiologic findings, in-hospital outcome and prognosis of stroke in patients with AF.

METHODS

All patients who were admitted due to an stroke in our Hospital since March 1, 1995 from May 15, 1997 have been analysed. They were divided in two groups, according to the presence or not of AF and we analysed: vascular risk factors, clinical characteristics, radiologic findings, in-hospital outcome and Barthel index and Canadian score on admission and at discharge.

RESULTS

747 patients were analysed, 205 (27.4%) with AF and 542 without it. The mean age was higher in patients with AF (p < 0.001). The ischemic stroke/cerebral hemorrhage ratio was higher in patients with AF than in those without it (OR: 3.91). We found in 3/4 of patients with AF, clinical data supporting the embolic etiology. In the AF group, Barthel index on admission and at discharge and Canadian score on admission were significantly lower. Patients with AF had more complications, a higher mortality rate, longer hospital stays and lower discharge rate to their own home.

CONCLUSIONS

AF is independently related with a greater severity and worse outcome in patients suffering acute stroke. These findings emphasize the importance of stroke prevention in patients with AF.