Open Access
Open access
Wiley
Journal of the American Heart Association
,  volume 11 ,  issue 4

Ischemic Stroke Severity and Mortality in Patients With and Without Atrial Fibrillation

Naja E. Vinding 1
, 
Soren Risom Kristensen 1
, 
Rasmus Rørth 1
, 
Jawad H. Butt 1
, 
Lauge Østergaard 1
, 
Jonas B Olesen 2
, 
C. Torp-Pedersen 3, 4
, 
Gunnar H. Gislason 2, 5
, 
Lars Køber 1
, 
Christina Kruuse 6, 7
, 
Søren P. Johnsen 8
, 
Emil L Fosbøl 1
1
 
2
 
3
 
Department of Cardiology and Clinical Investigation Nordsjaellands Hospital Hilerød Denmark | 
4
 
5
 
The Danish Heart Foundation Copenhagen Denmark | 
6
 
7
 
8
 
Publication type: Journal Article
Publication date: 2022-02-12
Wiley
scimago Q1
wos Q1
SJR: 2.189
CiteScore: 8.5
Impact factor: 5.3
ISSN: 20479980
Cardiology and Cardiovascular Medicine
Abstract
Background
Our objective was to investigate stroke severity and subsequent rate of mortality among patients with and without atrial fibrillation (AF). Contemporary data on stroke severity and prognosis in patients with AF are lacking.
Methods and Results
First‐time ischemic stroke patients from the Danish Stroke Registry (January 2005–December 2016) were included in an observational study. Patients with AF were matched 1:1 by sex, age, calendar year, and CHA 2 DS 2 ‐VASc score with patients without AF. Stroke severity was determined by the Scandinavian Stroke Scale (0–58 points). The rate of death was estimated by Kaplan‐Meier plots and multivariable Cox regression. Among 86 458 identified patients with stroke, 17 205 had AF. After matching, 14 662 patients with AF and 14 662 patients without AF were included (51.8% women; median age, 79.6 years [25th–75th percentile, 71.8–86.0]). More patients with AF had very severe stroke (0–14 points) than patients without AF (13.7% versus 7.9%, P <0.01). The absolute rates of 30‐day and 1‐year mortality were significantly higher for patients with AF (12.1% and 28.4%, respectively) versus patients without AF (8.7% and 21.8%, respectively). This held true in adjusted models for 30‐day mortality (hazard ratio [HR], 1.40 [95% CI, 1.30–1.51]). However, this association became nonsignificant when additionally adjusting for stroke severity (HR, 1.10 [95% CI, 1.00–1.23]). AF was associated with a higher rate of 1‐year mortality (HR, 1.39 [95% CI, 1.32–1.46]), although it was mediated by stroke severity (HR, 1.15 [95% CI, 1.09–1.23], model including stroke severity).
Conclusions
In a contemporary nationwide cohort of patients with ischemic stroke, patients with AF had more severe strokes and higher mortality than patients without AF. The difference in mortality was mainly driven by stroke severity.
Found 
Found 

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GOST Copy
Vinding N. E. et al. Ischemic Stroke Severity and Mortality in Patients With and Without Atrial Fibrillation // Journal of the American Heart Association. 2022. Vol. 11. No. 4.
GOST all authors (up to 50) Copy
Vinding N. E., Kristensen S. R., Rørth R., Butt J. H., Østergaard L., Olesen J. B., Torp-Pedersen C., Gislason G. H., Køber L., Kruuse C., Johnsen S. P., Fosbøl E. L. Ischemic Stroke Severity and Mortality in Patients With and Without Atrial Fibrillation // Journal of the American Heart Association. 2022. Vol. 11. No. 4.
RIS |
Cite this
RIS Copy
TY - JOUR
DO - 10.1161/JAHA.121.022638
UR - https://doi.org/10.1161/JAHA.121.022638
TI - Ischemic Stroke Severity and Mortality in Patients With and Without Atrial Fibrillation
T2 - Journal of the American Heart Association
AU - Vinding, Naja E.
AU - Kristensen, Soren Risom
AU - Rørth, Rasmus
AU - Butt, Jawad H.
AU - Østergaard, Lauge
AU - Olesen, Jonas B
AU - Torp-Pedersen, C.
AU - Gislason, Gunnar H.
AU - Køber, Lars
AU - Kruuse, Christina
AU - Johnsen, Søren P.
AU - Fosbøl, Emil L
PY - 2022
DA - 2022/02/12
PB - Wiley
IS - 4
VL - 11
PMID - 35156393
SN - 2047-9980
ER -
BibTex
Cite this
BibTex (up to 50 authors) Copy
@article{2022_Vinding,
author = {Naja E. Vinding and Soren Risom Kristensen and Rasmus Rørth and Jawad H. Butt and Lauge Østergaard and Jonas B Olesen and C. Torp-Pedersen and Gunnar H. Gislason and Lars Køber and Christina Kruuse and Søren P. Johnsen and Emil L Fosbøl},
title = {Ischemic Stroke Severity and Mortality in Patients With and Without Atrial Fibrillation},
journal = {Journal of the American Heart Association},
year = {2022},
volume = {11},
publisher = {Wiley},
month = {feb},
url = {https://doi.org/10.1161/JAHA.121.022638},
number = {4},
doi = {10.1161/JAHA.121.022638}
}
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