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(Stroke. 2001;32:2206.)
© 2001 American Heart Association, Inc.

Letters to the Editor

Re: Characteristics, Outcome, and Care of Stroke Associated With Atrial Fibrillation in Europe

Jagdish C. Sharma, FRCP

Stroke Unit, Kings Mill Center, Sutton-in-Ashfield, Nottinghamshire, UK, jsharma@lineone.net

To the Editor:

I read with great interest the detailed study of atrial fibrillation¹ in the context of acute stroke with particular relevance to the higher 3-month mortality of acute stroke patients who have atrial fibrillation (AF). We have previously reported² the higher 3-month mortality of AF patients presenting with a stroke. It should be recognized, however, that AF is only one aspect of the cardiovascular disease (CVD) of these patients and does not usually exist independently of other types of CVD (eg, ischemic heart disease and cardiac failure) in the older age group. It is vital that a more detailed assessment be performed for outcome measurement in patients with AF to take into account the presence of other CVDs. We have reported² that although AF was associated with a higher 3-month mortality in acute stroke patients (P=0.05), there was no significant association of AF with acute phase mortality, ie, death in acute wards (P=0.24). More significantly, we found that it is the presence of any degree of cardiac failure in addition to AF or other CVDs that is significantly associated with higher mortality both in the acute phase and at 3 months (P<0.001). Any future studies of the relationship of AF in the context of acute stroke should also study the influence of coexistent cardiac failure and other CVDs, eg, ischemic heart disease. In addition, it is also difficult to completely separate the independent influence of higher age on stroke mortality, because the patients with AF . . . [Full Text of this Article]

A. Di Carlo, MD; M. Lamassa, MD D. Inzitari, MD

National Research Council of Italy (CNR-CSFET), Italian Longitudinal Study on Aging, Florence, Italy
Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy

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