Causes of Ischemic Stroke in Patients with Atrial Fibrillation
Objective: Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting 1% of the adult population. However, ischemic strokes in patients with AF can be triggered by alternative mechanisms, especially in high-risk patients with additional vascular risk factors. In some patients, atheroth...
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| Format: | Article |
| Language: | English |
| Published: |
Galenos Yayinevi
2020-12-01
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| Series: | Türk Nöroloji Dergisi |
| Subjects: | |
| Online Access: | https://tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-60820&look4= |
| _version_ | 1797914409247440896 |
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| author | Yasemin Dinç Mustafa Bakar Bahattin Hakyemez |
| author_facet | Yasemin Dinç Mustafa Bakar Bahattin Hakyemez |
| author_sort | Yasemin Dinç |
| collection | DOAJ |
| description | Objective: Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting 1% of the adult population. However, ischemic strokes in patients with AF can be triggered by alternative mechanisms, especially in high-risk patients with additional vascular risk factors. In some patients, atherothrombotic mechanisms may cause stroke, and AF may be incidental or a symptom of atherosclerotic disease. In this case, it may be difficult to distinguish cardioembolic stroke from stroke due to large artery atherosclerosis. The aim of this study was to determine the causes of non-cardioembolic ischemic stroke in patients with non-valvular AF and to determine the risk factors for craniocervical atherosclerotic stenosis.
Materials and Methods: This study identified risk factors for craniocervical atherosclerotic stenosis in patients followed up at the Uludağ University Faculty of Medicine Department of Neurology with a diagnosis of ischemic stroke and non-valvular AF. In this study, 180 patients who were followed up with a diagnosis of non-valvular AF and acute ischemic stroke between January 1st, 2019 - March 1st 2020, in Uludağ University Faculty of Medicine Department of Neurology, were retrospectively included.
Results: In this study, the non-cardiac stroke rate was 20% in patients with non-valvular AF who had acute ischemic stroke. Ischemic stroke due to large vessel atherosclerosis was found in 14.4% of these patients, and 9.5% of all patients with AF were stented. When dermographic features, clinical features, and risk factors were analyzed for craniocervical atherosclerotic stenosis, a significant statistical result was obtained with male sex (p=0.020) and smoking (p<0.001).
Conclusion: Stroke is a heterogeneous group of diseases caused by many complex mechanisms. Prevention of stroke recurrence is possible by starting effective treatment early. The presence of critical artery stenosis in a patient with acute ischemic stroke with AF causes stroke recurrence and this relapse cannot be prevented by anticoagulant treatment. Angiographic evidence also revealed ethnic and racial differences in patients with acute ischemic stroke. Therefore, more precise information can be obtained through prospective studies in our population. |
| first_indexed | 2024-04-10T12:26:22Z |
| format | Article |
| id | doaj.art-2bbe493f29af4090ab5860e2542309d9 |
| institution | Directory Open Access Journal |
| issn | 1309-2545 |
| language | English |
| last_indexed | 2024-04-10T12:26:22Z |
| publishDate | 2020-12-01 |
| publisher | Galenos Yayinevi |
| record_format | Article |
| series | Türk Nöroloji Dergisi |
| spelling | doaj.art-2bbe493f29af4090ab5860e2542309d92023-02-15T16:15:08ZengGalenos YayineviTürk Nöroloji Dergisi1309-25452020-12-0126431131510.4274/tnd.2020.60820Causes of Ischemic Stroke in Patients with Atrial FibrillationYasemin Dinç0https://orcid.org/0000-0003-0342-5939Mustafa Bakar1https://orcid.org/0000-0001-5229-0001Bahattin Hakyemez2https://orcid.org/0000-0002-3425-0740Uludag University Faculty of Medicine, Department of Neurology, Bursa, TurkeyUludag University Faculty of Medicine, Department of Neurology, Bursa, TurkeyUludag University Faculty of Medicine, Department of Radiology, Bursa, TurkeyObjective: Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting 1% of the adult population. However, ischemic strokes in patients with AF can be triggered by alternative mechanisms, especially in high-risk patients with additional vascular risk factors. In some patients, atherothrombotic mechanisms may cause stroke, and AF may be incidental or a symptom of atherosclerotic disease. In this case, it may be difficult to distinguish cardioembolic stroke from stroke due to large artery atherosclerosis. The aim of this study was to determine the causes of non-cardioembolic ischemic stroke in patients with non-valvular AF and to determine the risk factors for craniocervical atherosclerotic stenosis. Materials and Methods: This study identified risk factors for craniocervical atherosclerotic stenosis in patients followed up at the Uludağ University Faculty of Medicine Department of Neurology with a diagnosis of ischemic stroke and non-valvular AF. In this study, 180 patients who were followed up with a diagnosis of non-valvular AF and acute ischemic stroke between January 1st, 2019 - March 1st 2020, in Uludağ University Faculty of Medicine Department of Neurology, were retrospectively included. Results: In this study, the non-cardiac stroke rate was 20% in patients with non-valvular AF who had acute ischemic stroke. Ischemic stroke due to large vessel atherosclerosis was found in 14.4% of these patients, and 9.5% of all patients with AF were stented. When dermographic features, clinical features, and risk factors were analyzed for craniocervical atherosclerotic stenosis, a significant statistical result was obtained with male sex (p=0.020) and smoking (p<0.001). Conclusion: Stroke is a heterogeneous group of diseases caused by many complex mechanisms. Prevention of stroke recurrence is possible by starting effective treatment early. The presence of critical artery stenosis in a patient with acute ischemic stroke with AF causes stroke recurrence and this relapse cannot be prevented by anticoagulant treatment. Angiographic evidence also revealed ethnic and racial differences in patients with acute ischemic stroke. Therefore, more precise information can be obtained through prospective studies in our population.https://tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-60820&look4=atrial fibrillationischemic cerebrovascular diseasecraniocervical atherosclerotic stenosis |
| spellingShingle | Yasemin Dinç Mustafa Bakar Bahattin Hakyemez Causes of Ischemic Stroke in Patients with Atrial Fibrillation Türk Nöroloji Dergisi atrial fibrillation ischemic cerebrovascular disease craniocervical atherosclerotic stenosis |
| title | Causes of Ischemic Stroke in Patients with Atrial Fibrillation |
| title_full | Causes of Ischemic Stroke in Patients with Atrial Fibrillation |
| title_fullStr | Causes of Ischemic Stroke in Patients with Atrial Fibrillation |
| title_full_unstemmed | Causes of Ischemic Stroke in Patients with Atrial Fibrillation |
| title_short | Causes of Ischemic Stroke in Patients with Atrial Fibrillation |
| title_sort | causes of ischemic stroke in patients with atrial fibrillation |
| topic | atrial fibrillation ischemic cerebrovascular disease craniocervical atherosclerotic stenosis |
| url | https://tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-60820&look4= |
| work_keys_str_mv | AT yasemindinc causesofischemicstrokeinpatientswithatrialfibrillation AT mustafabakar causesofischemicstrokeinpatientswithatrialfibrillation AT bahattinhakyemez causesofischemicstrokeinpatientswithatrialfibrillation |