The Effect of Atrial Fibrillation on Recanalization and Prognosis in Patients with Acute Ischemic Stroke Undergoing Mechanical Thrombectomy and/or Intravenous Thrombolysis

IF 0.4 4区 医学 Q4 NEUROSCIENCES Neurological Sciences and Neurophysiology Pub Date : 2023-01-01 DOI:10.4103/nsn.nsn_102_23
Hacı Ali Erdoğan, İbrahim Acır, Özlem Yalınkaya Albuz, Hülya Olgun, Vildan Ayşe Yayla
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Abstract

A BSTRACT Background: Atrial fibrillation (AF) is the most common cause of cardioembolic ischemic strokes. It causes large-vessel occlusions and a poor prognosis. Regardless of ischemic stroke etiology, hyperacute therapy strategies are effective treatment modalities. Methods: Patients who were diagnosed as having AF were classified as AF (+) and others without AF were classified as AF (-). It is not clear which treatment should be preferred in patients with stroke who are AF (+). We studied demographic characteristics, recanalization rates, and clinical outcomes in acute patients with ischemic stroke with or without nonvalvular AF who underwent hyperacute treatments. Results: We detected that clinical findings were more severe and the NIHSS scores were significantly higher at admission inpatients who were AF (+). In our study, mechanical thrombectomy rates were high in patients who were AF (+), whereas intravenous tissue plasminogen activator treatment rates were higher in patients who were AF (-). Thrombolysis in cerebral infarction scores were similar in our patient groups. We found high rates of both symptomatic (PH 2) and asymptomatic hemorrhagic transformation in patients who were AF (+) in 24 th -h cranial computed tomography. A positive correlation was found between symptom-admission, symptom-needle, and symptom-groin times and discharge-modified Rankin Scale scores regardless of the hyperacute treatments in all patient groups. Conclusion: As a result, physicians should focus on the diagnosis of AF, and appropriate anticoagulant treatment is important for primary prevention.
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心房颤动对急性缺血性卒中机械取栓和/或静脉溶栓患者再通和预后的影响
背景:心房颤动(AF)是心脏栓塞性缺血性中风最常见的原因。它会导致大血管闭塞和预后不良。无论缺血性脑卒中的病因,超急性治疗策略是有效的治疗方式。方法:将诊断为AF的患者分为AF(+)组,将无AF的患者分为AF(-)组。目前尚不清楚对于AF(+)的脑卒中患者应首选哪种治疗方法。我们研究了接受超急性治疗的伴有或不伴有非瓣膜性房颤的急性缺血性卒中患者的人口学特征、再通率和临床结果。结果:我们发现AF(+)住院患者入院时临床表现更严重,NIHSS评分明显更高。在我们的研究中,AF(+)患者的机械取栓率较高,而AF(-)患者的静脉组织纤溶酶原激活剂治疗率较高。两组患者脑梗死溶栓评分相似。我们发现,在24小时的颅脑计算机断层扫描中,AF(+)患者的症状性(PH 2)和无症状性出血转化的发生率都很高。在所有患者组中,不论采用何种超急性治疗,症状-入院、症状-针刺、症状-腹股沟时间与出院修正Rankin量表评分之间均存在正相关。结论:医师应重视房颤的诊断,适当的抗凝治疗对房颤的一级预防至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.70
自引率
25.00%
发文量
4
审稿时长
26 weeks
期刊介绍: Neurological Sciences and Neurophysiology is the double blind peer-reviewed, open access, international publication organ of Turkish Society of Clinical Neurophysiology EEG-EMG. The journal is a quarterly publication, published in March, June, September and December and the publication language of the journal is English.
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