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Association between Rapid Ventricular Response and Stroke Outcomes in Atrial Fibrillation-Related Cardiac Embolic Stroke.
- Source :
-
Cerebrovascular diseases (Basel, Switzerland) [Cerebrovasc Dis] 2024; Vol. 53 (1), pp. 69-78. Date of Electronic Publication: 2023 Jul 03. - Publication Year :
- 2024
-
Abstract
- Introduction: 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.<br />Methods: 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.<br />Results: We studied 568 AF-stroke patients, among whom 86 (15.1%) had RVR. Patients with RVR had higher initial NIHSS score (p &lt; 0.001) and poor outcome at 3 months (p = 0.004) than those without RVR. The presence of RVR [adjusted odds ratio (aOR) = 2.13; p = 0.013] was associated with initial stroke severity, but not with END and functional outcome. Otherwise, initial stroke severity [aOR = 1.27; p = &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.<br />Conclusion: 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.<br /> (© 2023 S. Karger AG, Basel.)
Details
- Language :
- English
- ISSN :
- 1421-9786
- Volume :
- 53
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Cerebrovascular diseases (Basel, Switzerland)
- Publication Type :
- Academic Journal
- Accession number :
- 37399789
- Full Text :
- https://doi.org/10.1159/000531386