J Neurol Res

Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Neurol Res and Elmer Press Inc

Journal website https://www.neurores.org

Original Article

Volume 12, Number 3, October 2022, pages 121-127

The Impact of Atrial Fibrillation on the Outcome of Ischemic Stroke Treated With Thrombolysis or Endovascular Therapy

**Table 1.** Demographic Data, Vascular Risk Factors and Baseline Assessments: Patient Classification According to Those With and Without Atrial Fibrillation
Variables	AF- (n = 524)	AF+ (n = 196)	P value
^aMeasure is continuous (results are mean and standard deviation). AF: atrial fibrillation; AF-: without atrial fibrillation; AF+: with atrial fibrillation; EVT: endovascular therapy; mRS: modified Rankin Scale; NIHSS: National Institutes of Health Stroke Scale; SBP: systolic blood pressure; TIA: transient ischemic attack.
Age^a	66.9 (15.2)	78.2 (12.5)	< 0.0001
Sex (female)	227 (43.3%)	109 (55.6%)	0.004
White	417 (82.7%)	166 (88.8%)	0.03
Asian	28 (5.6%)	10 (5.3%)
Black/African American	53 (10.5%)	7 (3.7%)
Native American	2 (0.4%)	3 (1.6%)
Pacific Islander	1 (0.2%)	1 (0.5%)
Not Hispanic/Latino	412 (78.6%)	155 (79.1%)	0.79
Hispanic/Latino	108 (20.6%)	38 (19.4%)
Current smoker	84 (16%)	6 (3.1%)	< 0.0001
Hypertension	348 (66.4%)	146 (74.5%)	0.10
Diabetes	128 (24.4%)	42 (21.4%)	0.46
Coronary artery disease	94 (17.9%)	46 (23.5%)	0.18
Congestive heart failure	50 (9.5%)	42 (21.4%)	0.0001
Stroke/TIA	122 (23.3%)	46 (23.5%)	0.57
Anticoagulants	4 (0.8%)	6 (3.1%)	0.05
Baseline SBP^a	150.7 (25.6)	150.6 (26)	0.93
Baseline glucose^a	133 (46.6)	141.3 (64.8)	0.11
NIHSS > 5 at baseline	338 (64.6%)	151 (77.4%)	0.001
Baseline mRS > 2	46 (9%)	39 (20.3%)	< 0.0001
EVT	61 (11.6%)	39 (19.9%)	0.006
Thrombolysis	435 (83%)	140 (71.4%)	0.0008
Thrombolysis and EVT	28 (5.3%)	17 (8.7%)	0.14

Table 1. Demographic Data, Vascular Risk Factors and Baseline Assessments: Patient Classification According to Those With and Without Atrial Fibrillation

Variables

AF- (n = 524)

AF+ (n = 196)

P value

^aMeasure is continuous (results are mean and standard deviation). AF: atrial fibrillation; AF-: without atrial fibrillation; AF+: with atrial fibrillation; EVT: endovascular therapy; mRS: modified Rankin Scale; NIHSS: National Institutes of Health Stroke Scale; SBP: systolic blood pressure; TIA: transient ischemic attack.

Age^a

66.9 (15.2)

78.2 (12.5)

< 0.0001

Sex (female)

227 (43.3%)

109 (55.6%)

0.004

White

417 (82.7%)

166 (88.8%)

0.03

Asian

28 (5.6%)

10 (5.3%)

Black/African American

53 (10.5%)

7 (3.7%)

Native American

2 (0.4%)

3 (1.6%)

Pacific Islander

1 (0.2%)

1 (0.5%)

Not Hispanic/Latino

412 (78.6%)

155 (79.1%)

0.79

Hispanic/Latino

108 (20.6%)

38 (19.4%)

Current smoker

84 (16%)

6 (3.1%)

< 0.0001

Hypertension

348 (66.4%)

146 (74.5%)

0.10

Diabetes

128 (24.4%)

42 (21.4%)

0.46

Coronary artery disease

94 (17.9%)

46 (23.5%)

0.18

Congestive heart failure

50 (9.5%)

42 (21.4%)

0.0001

Stroke/TIA

122 (23.3%)

46 (23.5%)

0.57

Anticoagulants

4 (0.8%)

6 (3.1%)

0.05

Baseline SBP^a

150.7 (25.6)

150.6 (26)

0.93

Baseline glucose^a

133 (46.6)

141.3 (64.8)

0.11

NIHSS > 5 at baseline

338 (64.6%)

151 (77.4%)

0.001

Baseline mRS > 2

46 (9%)

39 (20.3%)

< 0.0001

EVT

61 (11.6%)

39 (19.9%)

0.006

Thrombolysis

435 (83%)

140 (71.4%)

0.0008

Thrombolysis and EVT

28 (5.3%)

17 (8.7%)

0.14

**Table 2.** A Comparison Between the Rate of Successful Recanalization and Hemorrhagic Transformation in Cases With and Without Atrial Fibrillation: The Result of Adjusted Logistics Regression
Variables	TICI < 2b	sICH
^aFemale. ^bNever smoked or ex-smoker. ^cSeverity was defined as baseline NIHSS > 5. ^dDisability was defined as baseline modified Rankin Scale > 2. P-values less than 0.0001 are reported as zero. TICI: thrombolysis in cerebral infarction; sICH: symptomatic intracranial hemorrhage; CHF: congestive heart failure; OR: odds ratio; CI: confidence interval; SBP: systolic blood pressure; AF+: with atrial fibrillation.
Age	0.96 (0.9 - 1.02)	0.1637	1.02 (0.99 - 1.06)	0.1909
Sex^a	0.19 (0.04 - 0.92)	0.0392	0.65 (0.26 - 1.64)	0.365
SBP	1.03 (1 - 1.06)	0.0429	1.01 (0.99 - 1.02)	0.515
Smokers^b	0.22 (0.02 - 3.01)	0.2587	2.04 (0.52 - 7.93)	0.3059
Glucose	1 (0.99 - 1.02)	0.5451	1 (1 - 1.01)	0.3189
Severity^c	4.71 (0.44 - 50.88)	0.2015	2.99 (0.84 - 10.61)	0.0899
Disability^d	0.91 (0.14 - 6.06)	0.9217	0.39 (0.08 - 1.81)	0.2285
CHF	1.97 (0.26 - 14.96)	0.5138	1.78 (0.61 - 5.26)	0.294
Anticoagulants	0.64 (0.05 - 7.9)	0.7306	0 (0 - Inf)	0.9878
AF+	1.19 (0.29 - 4.84)	0.8097	1.18 (0.44 - 3.17)	0.7433

Table 2. A Comparison Between the Rate of Successful Recanalization and Hemorrhagic Transformation in Cases With and Without Atrial Fibrillation: The Result of Adjusted Logistics Regression

Variables

TICI < 2b

sICH

OR (CI)

^aFemale. ^bNever smoked or ex-smoker. ^cSeverity was defined as baseline NIHSS > 5. ^dDisability was defined as baseline modified Rankin Scale > 2. P-values less than 0.0001 are reported as zero. TICI: thrombolysis in cerebral infarction; sICH: symptomatic intracranial hemorrhage; CHF: congestive heart failure; OR: odds ratio; CI: confidence interval; SBP: systolic blood pressure; AF+: with atrial fibrillation.

Age

0.96 (0.9 - 1.02)

0.1637

1.02 (0.99 - 1.06)

0.1909

Sex^a

0.19 (0.04 - 0.92)

0.0392

0.65 (0.26 - 1.64)

0.365

SBP

1.03 (1 - 1.06)

0.0429

1.01 (0.99 - 1.02)

0.515

Smokers^b

0.22 (0.02 - 3.01)

0.2587

2.04 (0.52 - 7.93)

0.3059

Glucose

1 (0.99 - 1.02)

0.5451

1 (1 - 1.01)

0.3189

Severity^c

4.71 (0.44 - 50.88)

0.2015

2.99 (0.84 - 10.61)

0.0899

Disability^d

0.91 (0.14 - 6.06)

0.9217

0.39 (0.08 - 1.81)

0.2285

CHF

1.97 (0.26 - 14.96)

0.5138

1.78 (0.61 - 5.26)

0.294

Anticoagulants

0.64 (0.05 - 7.9)

0.7306

0 (0 - Inf)

0.9878

AF+

1.19 (0.29 - 4.84)

0.8097

1.18 (0.44 - 3.17)

0.7433

**Table 3.** A Comparison Between Discharge Disposition and Poststroke Disability in Cases With and Without Atrial Fibrillation: The Result of Adjusted Logistics Regression
Variables	Discharge disposition	Modified Rankin Scale
^aFemale. ^bNever smoked or ex-smoker. ^cSeverity was defined as baseline NIHSS > 5. ^dDisability was defined as baseline modified Rankin Scale > 2. P-values less than 0.0001 are reported as zero. SBP: systolic blood pressure; AF+: with atrial fibrillation; CHF: congestive heart failure; OR: odds ratio; CI: confidence interval; SNF: skilled nursing facility; TICI: thrombolysis in cerebral infarction.
Age	1.04 (1.02 - 1.06)	0	1.04 (1.01 - 1.06)	0.0117	1.04 (1.02 - 1.07)	0	0.97 (0.96 - 0.98)	0	0.98 (0.96 - 0.99)	0.0029	0.95 (0.93 - 0.97)	0
Sex^a	1.03 (0.67 - 1.57)	0.8913	1.15 (0.59 - 2.22)	0.6846	1.03 (0.63 - 1.68)	0.9026	1.02 (0.71 - 1.46)	0.9315	1.05 (0.71 - 1.55)	0.8098	0.81 (0.46 - 1.42)	0.4615
SBP	1.01 (1.01 - 1.02)	0.0015	1.01 (1 - 1.02)	0.1129	1.02 (1.01 - 1.03)	0.0016	1 (0.99 - 1)	0.2487	1 (0.99 - 1)	0.3718	1 (0.98 - 1.01)	0.4421
Smokers^b	1.1 (0.55 - 2.19)	0.7904	0.4 (0.09 - 1.84)	0.2382	1.49 (0.7 - 3.16)	0.2982	0.85 (0.5 - 1.46)	0.5569	0.77 (0.44 - 1.36)	0.3645	1.53 (0.56 - 4.18)	0.4086
Glucose	1 (1 - 1)	0.3601	1 (1 - 1.01)	0.1462	1 (1 - 1)	0.7929	1 (1 - 1)	0.3204	1 (1 - 1)	0.4	1 (1 - 1)	0.8785
Severity^c	6.61 (3.68 - 11.87)	0	6.73 (2.51 - 18.05)	0.0002	7.06 (3.52 - 14.13)	0	0.22 (0.15 - 0.33)	0	0.28 (0.18 - 0.43)	0	0.12 (0.05 - 0.26)	0
Disability^d	1.24 (0.7 - 2.19)	0.4639	0.9 (0.36 - 2.26)	0.8298	1.41 (0.75 - 2.64)	0.2819	0.13 (0.06 - 0.28)	0	0.15 (0.07 - 0.35)	0	0.11 (0.04 - 0.27)	0
CHF	1.87 (1.05 - 3.32)	0.033	1.68 (0.71 - 3.98)	0.2395	2.04 (1.07 - 3.9)	0.0308	0.7 (0.41 - 1.2)	0.1997	0.67 (0.37 - 1.21)	0.1864	0.66 (0.3 - 1.43)	0.2923
Anticoagulants	3.7 (0.75 - 18.27)	0.1079	4.77 (0.4 - 56.63)	0.2154	3.85 (0.66 - 22.53)	0.1354	1.25 (0.31 - 5.11)	0.7521	1.82 (0.34 - 9.74)	0.4839	1.36 (0.14 - 12.84)	0.7906
AF+	1 (0.63 - 1.59)	0.9998	0.95 (0.46 - 1.97)	0.8932	0.96 (0.56 - 1.63)	0.8693	0.73 (0.48 - 1.11)	0.1403	0.75 (0.47 - 1.2)	0.2284	0.67 (0.37 - 1.21)	0.1853

Table 3. A Comparison Between Discharge Disposition and Poststroke Disability in Cases With and Without Atrial Fibrillation: The Result of Adjusted Logistics Regression

Variables

Discharge disposition

Modified Rankin Scale

Hospice/SNF/death

In-hospital death

Hospice/SNF

0 - 2 vs. 3 - 6

0 - 2 vs. 3 - 5

0 - 2 vs. 6 (death)

OR (CI)

^aFemale. ^bNever smoked or ex-smoker. ^cSeverity was defined as baseline NIHSS > 5. ^dDisability was defined as baseline modified Rankin Scale > 2. P-values less than 0.0001 are reported as zero. SBP: systolic blood pressure; AF+: with atrial fibrillation; CHF: congestive heart failure; OR: odds ratio; CI: confidence interval; SNF: skilled nursing facility; TICI: thrombolysis in cerebral infarction.

Age

1.04 (1.02 - 1.06)

1.04 (1.01 - 1.06)

0.0117

1.04 (1.02 - 1.07)

0.97 (0.96 - 0.98)

0.98 (0.96 - 0.99)

0.0029

0.95 (0.93 - 0.97)

Sex^a

1.03 (0.67 - 1.57)

0.8913

1.15 (0.59 - 2.22)

0.6846

1.03 (0.63 - 1.68)

0.9026

1.02 (0.71 - 1.46)

0.9315

1.05 (0.71 - 1.55)

0.8098

0.81 (0.46 - 1.42)

0.4615

SBP

1.01 (1.01 - 1.02)

0.0015

1.01 (1 - 1.02)

0.1129

1.02 (1.01 - 1.03)

0.0016

1 (0.99 - 1)

0.2487

1 (0.99 - 1)

0.3718

1 (0.98 - 1.01)

0.4421

Smokers^b

1.1 (0.55 - 2.19)

0.7904

0.4 (0.09 - 1.84)

0.2382

1.49 (0.7 - 3.16)

0.2982

0.85 (0.5 - 1.46)

0.5569

0.77 (0.44 - 1.36)

0.3645

1.53 (0.56 - 4.18)

0.4086

Glucose

1 (1 - 1)

0.3601

1 (1 - 1.01)

0.1462

1 (1 - 1)

0.7929

1 (1 - 1)

0.3204

1 (1 - 1)

0.4

1 (1 - 1)

0.8785

Severity^c

6.61 (3.68 - 11.87)

6.73 (2.51 - 18.05)

0.0002

7.06 (3.52 - 14.13)

0.22 (0.15 - 0.33)

0.28 (0.18 - 0.43)

0.12 (0.05 - 0.26)

Disability^d

1.24 (0.7 - 2.19)

0.4639

0.9 (0.36 - 2.26)

0.8298

1.41 (0.75 - 2.64)

0.2819

0.13 (0.06 - 0.28)

0.15 (0.07 - 0.35)

0.11 (0.04 - 0.27)

CHF

1.87 (1.05 - 3.32)

0.033

1.68 (0.71 - 3.98)

0.2395

2.04 (1.07 - 3.9)

0.0308

0.7 (0.41 - 1.2)

0.1997

0.67 (0.37 - 1.21)

0.1864

0.66 (0.3 - 1.43)

0.2923

Anticoagulants

3.7 (0.75 - 18.27)

0.1079

4.77 (0.4 - 56.63)

0.2154

3.85 (0.66 - 22.53)

0.1354

1.25 (0.31 - 5.11)

0.7521

1.82 (0.34 - 9.74)

0.4839

1.36 (0.14 - 12.84)

0.7906

AF+

1 (0.63 - 1.59)

0.9998

0.95 (0.46 - 1.97)

0.8932

0.96 (0.56 - 1.63)

0.8693

0.73 (0.48 - 1.11)

0.1403

0.75 (0.47 - 1.2)

0.2284

0.67 (0.37 - 1.21)

0.1853