Goel Deepak, Gupta Rekha, Keshri Tulika, Rana Sanyal
Department of Neurology, Himalayan Hospital of Medical Sciences, Swami Ram Himalayan University, Dehradun, Uttarakhand, India.
Department of Neurocritical Care, Max Institute of Neurosciences, Dehradun, Uttarakhand, India.
Brain Circ. 2020 Feb 18;6(1):19-25. doi: 10.4103/bc.bc_19_19. eCollection 2020 Jan-Mar.
Secondary stroke prevention is as important as the treatment of acute ischemic stroke in regards to halt neurological disability and to lower down mortality due to recurrent episodes. The effective secondary prevention depends on finding the specific risk factors leading to cerebro-vascular insult.
We aimed this study to find prevalence of persistent/Paroxysmal AF in stroke patients from single center hospital based study.
Hospital based study enrolled all prospective patients of acute ischemic stroke from January 2016 to December 2018. All patients were subjected to test for risk factors analysis after detail clinical history and examination of these patients. Following variables were recorded; age, gender, stroke territory, stroke severity by NIHSS (National Institute of Health Stroke Scale), LDL-C (Low Density Lipoprotein - cholesterol) of more than 100 mg/dl, HBA1C (Glycosylated Hemoglobin) of more than 6.5, Homocystine of more than 15 Mc Mol/L, 2D-Echocardiographic abnormalities, electrocardiography/24 hour Holter Monitoring, cerebral angiography of brain and neck findings and outcome of patients in 90 days follow-up based on Modified Rankin Scale.
Total 246 patients (69.5% men and 30.5% women) of Acute Ischemic stroke were recorded during study period. Mean age was 61.4 years, with 31 (12.4%) patients were below 45 years. Atrial fibrillation (AF) was detected either on conventional ECG or 24 hour Holter monitoring in 62 (25.2%) patients.
Stroke with AF is found in 25% patients, more common in elderly, female large atrial size and associated with poor outcome.
二级卒中预防对于阻止神经功能残疾以及降低复发性发作导致的死亡率而言,与急性缺血性卒中的治疗同样重要。有效的二级预防取决于找出导致脑血管损伤的特定风险因素。
本研究旨在通过单中心医院研究找出卒中患者中持续性/阵发性房颤的患病率。
基于医院的研究纳入了2016年1月至2018年12月期间所有急性缺血性卒中的前瞻性患者。在详细了解这些患者的临床病史并进行检查后,所有患者均接受了风险因素分析测试。记录了以下变量:年龄、性别、卒中区域、美国国立卫生研究院卒中量表(NIHSS)评估的卒中严重程度、低密度脂蛋白胆固醇(LDL-C)高于100mg/dl、糖化血红蛋白(HBA1C)高于6.5、同型半胱氨酸高于15μmol/L、二维超声心动图异常、心电图/24小时动态心电图监测、脑和颈部的脑血管造影结果以及基于改良Rankin量表的90天随访期患者结局。
研究期间共记录了246例急性缺血性卒中患者(男性占69.5%,女性占30.5%)。平均年龄为61.4岁,其中31例(12.4%)患者年龄低于45岁。在62例(25.2%)患者的常规心电图或24小时动态心电图监测中检测到房颤(AF)。
25%的患者存在伴有房颤的卒中,在老年人、女性、心房较大者中更为常见,且与不良结局相关。