Alcalde Tirado P, Ribera Casado J M
Servicio de Geriatría, Hospital Clínico, San Carlos, Madrid.
An Med Interna. 1995 Aug;12(8):369-73.
Cerebrovascular disease is the third cause of death in much of the occidental countries. Nowadays atrial fibrillation (AF) is well recognized as an independent and important risk factor for stroke in elderly people. Our aim is to know the frequency of AF in the patients who were admitted to a hospital for an ischemic stroke, the clinical risk factors associated to brain embolism and the prevention of cardiogenic brain embolism.
164 patients older than 65 years were admitted to the hospital during 5 months, those who were suspected of stroke were studied prospectively. Only the patients who had a cerebral infarction demonstrated by computed tomography of brain with a neurological alteration of at least 3 days were included in the study.
Fifty eight patients (27 men) met the ischemic stroke criteria. 22 of them had AF (9 men). Three of them had no other clinical risk factors associated and 19 had: hypertension in 10 cases, 8 had previous stroke and 1 had a episode of congestive heart failure 3 months before being admitted in the hospital. At the moment of admission only 4 patients were treated with aspirin and none with warfarin.
a) 38% of elderly patients with stroke have AF. b) The association with other clinical factors that increase the risk of brain embolism is high (86%). c) The percentage of patients having a preventing treatment for cardiogenic embolism is very low.
