In:
Cerebrovascular Diseases, S. Karger AG
Abstract:
〈 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.
Type of Medium:
Online Resource
ISSN:
1015-9770
,
1421-9786
Language:
English
Publisher:
S. Karger AG
Publication Date:
2023
detail.hit.zdb_id:
1482069-9
