Henrikas Kazlauskas, Rima Radžiuvienė, Vinsas Janušonis
Abstract
Atrial fibrillation (AF) is an important stroke risk factor increasing the risk five-fold. The purpose of the study was to determine the impact of AF on patients with acute stroke. Data of 96 patients with acute stroke who were treated in the Stroke unit of Klaipėda university hospital, 01/06/2007 through 31/12/2010, were prospectively studied. Patients aged 45 to 92 were analysed, average age being 71.6 (SN10.7); 34.4 % of the patients were women. Patients were divided into two groups (with or without AF) on the basis of atrial fibrillation diagnosis in the anamnesis and confirmed during the hospitalisation. The analysis included patients with ischemic and hemorrhagic stroke. All patients received brain computed tomography and electrocardiogram. At arrival and discharge from hospital, all patients had their neurological state in the acute stage of stroke evaluated using Scandinavian Stroke Scale (SSS); their state of consciousness, cognitive functions and functional status were assessed using Glasgow coma scale, mini-mental State Examination (MMSE) and modified Rankin Scale (mRS), respectively. The arithmetic mean of parameters and standard deviation (SD) were subjected to analysis. The relationship between symptoms was assessed applying Pearson’s correlation coefficient (r) and chi-square criterion (c 2). The differences in symptoms were considered as statistically significant (p<0.05) or statistically insignificant (p >0.05). The data were processed using SPSS 11.5. The study found that 27 stroke patients (28.1%) had AF. Based on anamnestic data, statistically significant difference between the analysed groups was established when assessing heart failure – 11 cases (15.9%) in the group of patients without AF and 11 cases (40.7%) in the group of patients with AF, (p=0.009) – as well as arterial hypertension – 40 cases (60.6%) and 23 cases (85.2%), (p=0.021), in two groups, respectively. The analysis of the relationship between vascular risk factors and AF revealed that statistically significantly higher percentage of patients with AF have more than three vascular risk factors (20% of patients with AF and 5.7% of patients without AF, (p=0.026)). Within 3 hours of acute stroke onset, statistically significantly higher number of patients with AF arrived in hospital (62 cases in AF patients and 27 cases in patients without AF, p=0.001). When analysing the state of consciousness in the acute stage of ischemic stroke using the Glasgow Coma Scale, statistically significantly lower average score was determined in the group of patients with PV as compared to the non-AF patients group: 13.4 (SD 2.6) and 14.4 (SD 1.6), respectively (p = 0.021). About half of patients with AF (48.8%) were diagnosed with heart failure NYHA class II/III compared with patients without AF (11.5%). The study concluded that more acute stroke patients with AF arrived in hospital within the three hours period than patients without AF. More than three of vascular factors were observed in one fifth of the patients with AF (20%) and only in about 6 % of AF-free patients. The assessment of the state of consciousness using Glasgow coma scale of acute stroke patients with AF proved it to be statistically significantly worse, when compared to patients without AF. Heart failure NYHA class II/III was detected in statistically significantly higher number of acute stroke patients with AF as compared to the group of patients without AF.Article in Lithuanian
doi:10.5200/sm-hs.2012.083
Keyword(s): atrial fibrillation; acute stroke
DOI: 10.5200/328
Full Text: PDF