[Ischemic stroke associated with atrial fibrillation: the demographic and clinical characteristics and 30-day mortality in a hospital stroke registry. The European Community Stroke Project, Florence Unit].

The importance of atrial fibrillation (AF) as a risk factor for stroke is well known. The role of AF as a prognostic indicator of outcome in the acute phase of stroke has been less thoroughly investigated. We considered the 635 patients admitted over a 1-year period to two general hospitals in the area of Florence (Italy), in order to examine the demographic and clinical characteristics, risk factors of the patients presenting with stroke and AF, and to evaluate their post-stroke mortality rate. Of the 447 patients diagnosed as affected by ischemic stroke, 103 (23.05%) had AF. These patients were older, more often female, and had fewer risk factors for factors for atherosclerosis than patients without AF. The risk of death at 30 days after stroke was about double in patients with AF as compared to those without AF after control by Cox regression analysis for the effect of the other prognostic indicators of mortality. Demographic variations anticipated for the future in our country (progressive ageing of the population) would lead us to predict a proportional increase of these forms in the coming decades. Therapeutic measures of proven effectiveness for primary prevention of stroke in patients with AF seem to be taken to an extremely limited degree in Italy. Our data could thus serve as a stimulus to the reconsideration of therapeutic guidelines and may be useful for the establishment of health care policy orientations.