Will atrial fibrillation increase the incidence of symptomatic intracranial hemorrhage after treatment in acute stroke patients? 丨ISC2021

Compared with other stroke subtypes, patients with acute ischemic stroke (AIS) caused by atrial fibrillation (AFIB) may have more complications with intravenous thrombolysis or endovascular treatment (EVT).

The purpose of this study was to compare the incidence of symptomatic intracranial hemorrhage (sICH) in patients with and without a history of atrial fibrillation who received intravenous recombinant tissue plasminogen activator (IV rt-PA) and/or EVT.

The results of the study will be announced in the form of a poster abstract at the 2021 International Stroke Conference (ISC2021).

Author: Medical team doctors report NMT NMT ISC finishing compiler, please do not reprint without authorization.

Research introduction American scholar Reza Bavarsad Shahripour and others consecutively included stroke patients in an academic comprehensive stroke center from January 2004 to June 2020 for a retrospective analysis.

If these patients receive IVrt-PA and/or EVT within 24 hours of onset, they will be included in the study.

The researchers divided the patients into six groups: 1- without a history of atrial fibrillation with EVT treatment group; 2- with a history of atrial fibrillation with EVT treatment group; 3- without a history of atrial fibrillation with IV rt-PA+EVT treatment group; 4- atrial fibrillation The medical history used IV rt-PA+EVT treatment group; 5.
No history of atrial fibrillation used IV rt-PA treatment group; 6-Atrial fibrillation history used IV rt-PA treatment group.

The main outcome was defined as any sICH within 72 hours of treatment (as defined by NINDS).

The baseline demographic data was compared; the chi-square test was used to evaluate the difference in the incidence of sICH, and the logistic regression analysis was used to compare the differences between the groups.

 Main findings ➤ Finally, 720 AIS patients receiving acute treatment were included (IV rt-PA: n = 578; EVT: n = 100; IV rt-PA + EVT: n = 18).

There are significant differences in gender (p=0.
005), race (p=0.
002), smoking (p≤0.
001), drinking (p=0.
03), chronic heart failure (p=0.
01) and age (p<0.
0001) in each group .

The baseline NIHSS in group 4 was significantly increased (23, SD8, p≤0.
001).

 ➤ In the adjustment analysis, accept IV t-PA (OR1.
5 3, CI0.
47~4.
99, p=0.
48), EVT (OR0.
93, CI 0~∞, p=1.
0 0) or both ( Compared with patients without atrial fibrillation, there was no significant difference in the incidence of sICH in patients with atrial fibrillation (OR0.
2 5, CI0.
0 0~9.
0 7, p=0.
45).

There was no significant difference in the incidence of sICH in patients with/without atrial fibrillation (OR0.
93, CI 0-∞, p=1.
00) Conclusion In this study, atrial fibrillation is effective for AIS patients receiving intravenous rt-PA and/or EVT The incidence of sICH had no significant effect.

This study supports the safety of intravenous rt-PA, EVT and the combination of the two in the subgroup of patients with atrial fibrillation.

 Yimaitong compiled from: Does Atrial Fibrillation Impact Rate of Symptomatic Intracranial Hemorrhage in Acute Ischemic Stroke Patients Treated With rt-PA and/or Endovascular Treatment? ISC2021.
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