Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Atrial Fibrillation is Associated with CSVD and Prognosis in Patients with Ischemic Stroke
First author：Yicong Wang
Corresponding author：Yilong Wang
essential_information
- Person in charge：Yicong Wang
- Data Sources： CNSR-Ⅲ
- Number of papers：CNSR-Ⅲ20230202
- Published time：2024-10-23
2024-10-23
Published articles
Journal：CNS Neurosci Ther
Publication type: Original Research Article
IF(IF): 4.8
PMID: PMC11491548 Link To Pubmed Full text Download
Background And Purpose
Acute ischemic stroke has the characteristics of high incidence rate, high disability rate and high mortality rate, which has a strong burden on families and society. Atrial fibrillation is one of the key risk factors for stroke and the leading cause of cardiac embolism, with some patients having poor prognosis. CSVD has many imaging signs such as high white matter hyperintensities, lacunes, microbleeds, perivascular space, and cerebral atrophy, which have a profound impact on the patient's bowel movements, emotions, gait, and other aspects. It has been proved that there is correlation between cerebrovascular disease, intracranial atherosclerosis and stroke prognosis. This study further explores the interaction between atrial fibrillation, imaging phenotype of cerebral small vessel disease, and stroke prognosis, providing guidance for clinical work.
Method
The study data was from the Third China National Stroke Registry (CNSR-III), which is a nationwide, multicenter, prospective registry of acute ischemic cerebrovascular events including TIA and ischemic stroke in China. Based on medical history and auxiliary examinations, we determine the diagnosis of atrial fibrillation (AF). Five imaging markers including lacunes, white matter hyperintensity (WMH), cerebral microbleeds (CMBs) and perivascular spaces (PVS)，atrophy as well as the CSVD burden score and modified CSVD burden score were assessed. Logistic regression or ordinal logistic regression models with odds ratios (OR) or common odds ratio (cOR) were used to estimate the relationship between AF, CSVD and 12-month outcomes.
Conclusion
Among Chinese patients with acute ischemic stroke, those with AF were associated with a higher risk of 12-month mortality and stroke recurrence. When AF was combined with some CSVD imaging features such as lacunes, WMH, presence of CMBs or burdens, the 12-month poor prognosis worsened.
Main results
The average age was 62.40 ± 11.22 years old, and 8362 (68.65%) were men at baseline. Patients with AF had an increased risk of stroke recurrence and all-cause mortality at 12-month follow-up. Those with AF and CSVD imaging such as lacunes, white matter hyperintensity (WMH), and the presence of cerebral microbleeds (CMBs) had an increased risk of poor prognosis. And those with both AF and CSVD burden had an increased risk of worse prognosis at 12-month follow-up.