In:
Cerebrovascular Diseases, S. Karger AG
Kurzfassung:
〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Patients with atrial fibrillation-related stroke (AF-stroke) are prone to developing rapid ventricular response (RVR). We investigated whether RVR is associated with initial stroke severity, early neurological deterioration (END) and poor outcome at 3 months. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We reviewed patients who had AF-stroke between January 2017 and March 2022. RVR was defined as having heart rate & gt;100 beats per minute on initial electrocardiogram. Neurological deficit was evaluated with National Institutes of Health Stroke Scale (NIHSS) score at admission. END was defined as increase of ≥2 in total NIHSS score or ≥1 in motor NIHSS score within first 72 h. Functional outcome was score on modified Rankin Scale at 3 months. Mediation analysis was performed to examine potential causal chain in which initial stroke severity may mediate relationship between RVR and functional outcome. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 We studied 568 AF-stroke patients, among whom 86 (15.1%) had RVR. Patients with RVR had higher initial NIHSS score ( 〈 i 〉 p 〈 /i 〉 & lt; 0.001) and poor outcome at 3 months ( 〈 i 〉 p 〈 /i 〉 = 0.004) than those without RVR. The presence of RVR [adjusted odds ratio (aOR) = 2.13; 〈 i 〉 p 〈 /i 〉 = 0.013] was associated with initial stroke severity, but not with END and functional outcome. Otherwise, initial stroke severity [aOR = 1.27; 〈 i 〉 p 〈 /i 〉 = & lt;0.001] was significantly associated with functional outcome. Initial stroke severity as a mediator explained 58% of relationship between RVR and poor outcome at 3 months. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 In patients with AF-stroke, RVR was independently associated with initial stroke severity but not with END and functional outcome. Initial stroke severity mediated considerable proportion of association between RVR and functional outcome.
Materialart:
Online-Ressource
ISSN:
1015-9770
,
1421-9786
Sprache:
Englisch
Verlag:
S. Karger AG
Publikationsdatum:
2023
ZDB Id:
1482069-9
