Risk factors of ischaemic stroke in patients with atrial fibrillation

Introduction
Atrial fibrillation (AF) is a common arrhythmia and a major risk factor for stroke. However, this risk depends on the coexistence of other factors that predispose to stroke and AF.

Aim of the research
We evaluated which of the common clinical factors were most strongly associated with stroke in patients with AF compared to patients with sinus rhythm.

Material and methods
In this retrospective, observational, single-centre study we analysed patients with acute ischaemic stroke admitted to the neurology centre between 1 January 2013 and 30 April 2015, inclusive. Patients were divided into groups with and without AF. Multivariate logistic regression analysis was used to identify predictors of stroke in the AF group.

Results
A total of 2339 ischaemic stroke patients were included in the study (mean age: 73.26 ±12.38 years, 51% male). Of these, 29.1% had AF. Patients with stroke and AF were significantly older (p < 0.001), were more often female (p < 0.001), and had higher rates of hypertension (p < 0.001), coronary heart disease (p < 0.001), and heart failure (p < 0.001). Multivariate logistic regression analyses identified older age (OR = 1.043, p < 0.001), female gender (OR = 1.389, p = 0.001), heart failure (OR = 2.467, p < 0.001), and coronary heart disease (OR = 1.618, p < 0.001) as independent factors that increased the risk of AF-associated stroke.

Conclusions
Patients with stroke and AF had additional risk factors coexisting with arrhythmia. The detection of other potential causes of stroke in patients with AF is important to allow modification of some of them and to establish effective treatment to improve outcomes in this group of patients.