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Journal of Neurology
Published in: Journal of Neurology 11/2006

Open Access 01-11-2006 | ORIGINAL COMMUNICATION

Comparison of the impact of atrial fibrillation on the risk of early death after stroke in women versus men

Authors: Jaume Roquer, Ana Rodríguez-Campello, MD, Meritxell Gomis, MD, Angle Ois, MD, José Enrique Martínez-Rodríguez, MD, Elvira Munteis, MD, Jordi Jiménez Conde, MD, Joan Montaner, MD, PhD, José Álvarez Sabín, MD, PhD

Published in: Journal of Neurology | Issue 11/2006

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Abstract

Background

Atrial fibrillation (AF) is considered a predictive factor of poor clinical outcome in patients with an ischemic stroke (IS). This study addressed whether the impact of AF on the in-hospital mortality after first ever IS is different according to the patient’s gender.

Methods

We prospectively studied 1678 patients with first ever IS consecutively admitted to two University Hospitals. We recorded demographic data, vascular risk factors, and the stroke severity (NIHSS) at admission analyzing their impact on the in-hospital mortality and on the combined mortality-dependency at discharge using a Cox proportional hazards model. Two variable interactions between those factors independently related to in-hospital mortality and combined mortality-dependency at discharge were tested.

Results

Overall in-hospital mortality was 11.3%. Cox proportional hazards model showed that NIHSS at admission (HR: 1.178 [95% CI 1.149–1.207]), age (HR: 1.044 [95% CI 1.026–1.061]), AF (HR: 1.416 [95% CI 1.048–1.913]), male gender (HR: 1.853 [95% CI 1.323–2.192) and ischemic heart disease (HR: 1.527 [95% CI 1.063–2.192]) were independent predictors of in-hospital mortality. A significant interaction between gender and AF was found (p = 0.017). Data were stratified by gender, showing that AF was an independent predictor of poor outcome just for woman (HR: 2.183 [95% CI 1.403–3.396]; p < 0.001). The independent predictors of combined mortality-disability at discharge were NIHSS at admission (HR: 1.052 [95% CI 1.041–1.063]), age (HR: 1.011 [95% CI 1.004–1.018]), AF (HR: 1.197 [95% CI 1.031–1.390]), ischemic heart disease (HR: 1.222 [95% CI 1.004–1.488]), and smoking (HR: 1.262 [95% CI 1.033–1.541]).

Conclusions

The impact of AF is different in the twogenders and appears as a specific ischemic stroke predictor of in-hospital mortality just for women.
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Metadata
Title
Comparison of the impact of atrial fibrillation on the risk of early death after stroke in women versus men
Authors
Jaume Roquer
Ana Rodríguez-Campello, MD
Meritxell Gomis, MD
Angle Ois, MD
José Enrique Martínez-Rodríguez, MD
Elvira Munteis, MD
Jordi Jiménez Conde, MD
Joan Montaner, MD, PhD
José Álvarez Sabín, MD, PhD
Publication date
01-11-2006
Publisher
Steinkopff-Verlag
Published in
Journal of Neurology / Issue 11/2006
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-006-0250-8

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