Garrido-Hernández Tania, Amaya-Pascasio Laura, Quesada-López Miguel, Arjona-Padillo Antonio, García-Torrecillas Juan Manuel, Martínez-Sánchez Patricia
Department of Neurology, Stroke Centre, Torrecárdenas University Hospital, Almería, Spain.
Department of Emergency Medicine and Biomedical Research Unit, Torrecárdenas University Hospital, Almería, Spain.
Eur J Neurol. 2025 Jan;32(1):e16555. doi: 10.1111/ene.16555. Epub 2024 Nov 28.
Knowledge about the prevalence of atrial fibrillation (AF) in young stroke patients, as well as its associated factors and outcomes, is scarce. Our objective was to analyse it.
A retrospective analysis of the Spain Nationwide Minimum Basic Data Set (MBDS) (2016-2020), including ischaemic stroke (IS) patients aged 18 and 50 years, was conducted. Multivariate analyses were conducted to identify factors related to AF diagnosis.
Amongst 11,615 young IS patients, 426 (3.7%) had AF. Patients with AF were older (median age 45, interquartile range 42-48 vs. 44, interquartile range 40-47 years, p < 0.001) and displayed more incapacitating symptoms, higher in-hospital complications and were less often discharged home (p < 0.001). Multivariate analyses showed that older age (odds ratio [OR] 1.053, 95% confidence interval [CI] 1.032-1.074), obstructive sleep apnoea (OR 1.508, 95% CI 1.018-2.233), hyperthyroidism (OR 3.741, 95% CI 1.798-7.783), valvular heart disease (OR 6.094, 95% CI 4.261-8.716), congenital (OR 2.386, 95% CI 1.146-4.969) and non-congenital (OR 4.446, 95% CI 3.149-6.278) cardiopathies and heart failure (OR 3.098, 95% CI 1.905-5.037) were independently associated with higher probability of AF, whereas female gender (OR 0.647, 95% CI 0.516-0.812), diabetes mellitus (0.487, 95% CI 0.339-0.699), smoking (OR 0.617, 95% CI 0.501-0.759), patent foramen ovale (OR 0.210, 95% CI 0.111-0.396) and arterial dissection (OR 0.294, 95% CI 0.130-0.668) were associated with a lower probability.
In young IS patients, AF is associated with more in-hospital complications and disabling strokes. These findings emphasize the need to recognize AF in this demographic group, especially in patients with risk factors like hyperthyroidism and cardiomyopathies. Clinicians should assess these risk factors to ensure timely diagnosis and management of AF.
关于年轻卒中患者心房颤动（AF）的患病率及其相关因素和预后的知识较为匮乏。我们的目的是对此进行分析。
对西班牙全国最低基本数据集（MBDS）（2016 - 2020年）进行回顾性分析，纳入年龄在18至50岁的缺血性卒中（IS）患者。进行多变量分析以确定与AF诊断相关的因素。
在11,615例年轻IS患者中，426例（3.7%）患有AF。AF患者年龄更大（中位年龄45岁，四分位间距42 - 48岁，而无AF患者为44岁，四分位间距40 - 47岁，p < 0.001），表现出更多致残症状、更高的院内并发症发生率，且更少出院回家（p < 0.001）。多变量分析显示，年龄较大（比值比[OR] 1.053，95%置信区间[CI] 1.032 - 1.074）、阻塞性睡眠呼吸暂停（OR 1.508，95% CI 1.018 - 2.233）、甲状腺功能亢进（OR 3.741，95% CI 1.798 - 7.783）、瓣膜性心脏病（OR 6.094，95% CI 4.261 - 8.716）、先天性（OR 2.386，95% CI 1.146 - 4.969）和非先天性（OR 4.446，95% CI 3.149 - 6.278）心脏病以及心力衰竭（OR 3.098，95% CI 1.905 - 5.037）与AF发生概率较高独立相关，而女性性别（OR 0.647，95% CI 0.516 - 0.812）、糖尿病（0.487，95% CI 0.339 - 0.699）、吸烟（OR 0.617，95% CI 0.501 - 0.759）、卵圆孔未闭（OR 0.210，95% CI 0.111 - 0.396）和动脉夹层（OR 0.294，95% CI 0.130 - 0.668）与AF发生概率较低相关。
在年轻IS患者中，AF与更多的院内并发症和致残性卒中相关。这些发现强调了在这一人群中识别AF的必要性，尤其是在患有甲状腺功能亢进和心肌病等危险因素的患者中。临床医生应评估这些危险因素，以确保AF的及时诊断和管理。
