Aims
To compare the 1-year prognoses of patients with atrial fibrillation known before stroke (KAF) with those diagnosed after (AFDAS) and to explore the reasons for any observed differences.
Methods
420 ischemic stroke patients were assigned to the KAF and AFDAS group. Follow-up information for both groups included the incidence of ischemic stroke recurrence, poor neurofunctional outcomes, and all-cause mortality within one year after the original ischemic stroke episode. The differences in the two groups' prognoses were assessed, and Cox/logistic regression models were employed to identify the underlying factors influencing this prognostic gap.
Results
AFDAS had significantly lower rates of ischemic stroke recurrence (11.06% vs. 19.34%, P = 0.018) and poor neurofunctional outcome (25.48% vs. 36.79%, P = 0.012) compared to KAF. One-year all-cause mortality was similar between the two groups (7.69% vs. 9.91%, P = 0.424). AFDAS had a significantly lower risk of ischemic stroke recurrence even after adjusting for mortality factors (HR, 0.542; 95% CI, 0.325–0.903; P = 0.019). The incidence rate of ischemic stroke recurrence was significantly lower in AFDAS compared to KAF after adjustment for non-cardiac factors (HR, 0.561; 95% CI, 0.316–0.995; P = 0.042). However, there was no discernible difference in the two groups after adjustment for cardiac factors (HR, 0.659/0.588; 95% CI, 0.390–1.115/0.327–1.058; P = 0.120/0.077). The probability of a poor neurofunctional outcome was 3.758-fold higher in patients with recurrent ischemic stroke compared to those without recurrence (HR, 3.758; 95% CI, 1.587–8.900; P = 0.003). Compared to KAF, AFDAS was 88% less likely to have a poor neurofunctional outcome (HR, 0.120; 95% CI, 0.052–0.277; P < 0.001).
Conclusion
Patients with AFDAS have a better prognosis than those with KAF.
