Stroke, Vol 22, 169-174, Copyright © 1991 by American Heart Association
L Candelise, G Pinardi and A Morabito
We compared 211 consecutive patients who had acute ischemic hemispheric
stroke and atrial fibrillation with 837 consecutive patients who had stroke
without atrial fibrillation. The atrial fibrillation group included a
higher frequency of women, older subjects, and those with a severe
neurologic deficit, abnormal computed tomogram, and elevated heart rate.
The 1-month case-fatality rate in the atrial fibrillation group was 27%
while that in the group without atrial fibrillation was 14%. The 6-month
case-fatality rates in the two groups were 40% and 20%, respectively. The
risk of death attributable to atrial fibrillation, adjusted for the effect
of other prognostic factors, was significant at 1 month (relative risk =
1.55) and at 6 months (relative risk = 1.74). The causes of death were
equally distributed in the two groups during both the acute and subacute
phases. We conclude that atrial fibrillation is a negative prognostic
factor in patients hospitalized for acute stroke. Nevertheless, cerebral
embolism alone does not completely explain the increase in mortality for
stroke patients with atrial fibrillation. Other associated pathogenetic
mechanisms must also be taken into account.
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Mortality in acute stroke with atrial fibrillation. The Italian Acute Stroke Study Group
Istituto di Clinica Neurologica, Universita degli Studi di Milano, Italy.
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