The relation between atrial fibrillation and prognosis of intravenous thrombolysis in acute ischemic stroke patients

Objective To explore the relation between atrial fibrillation (AF) and short-and long-term prognosis of acute ischemic stroke treated with intravenous thrombolysis. Methods One hundred and twenty-three ischemic stroke patients who came from 5 large general hospitals in southwestern region of Zhejiang treated with recombinant tissue plasminogen activator within 4.5 hours from stroke onset were enrolled in this study.Patients were classified into 2 groups based on the presence or absence of AF: AF group (n=52) and non-AF group (n=71).Baseline characteristics and prognosis were compared between groups，and the correlation between AF and functional outcome after intravenous thrombolysis was analyzed by logistic regression analysis. Results The baseline National Institute of Health Stroke Scale (NIHSS) score in AF group was significantly higher than that of non-AF group (14 vs 11，U=1236.000，P=0.002).No difference was found for the reduction of NIHSS at 2 h and 7 d after thrombolytic therapy between these 2 groups.At day 90，patients in AF group accounted for less favorable outcome (Modified Rankin Scale score≤1) than that in non-AF group (21.2% (11/52) vs 43.7% (31/71)，χ2=6.763，P=0.009).Logistic regression analysis revealed that baseline NIHSS score>10 was significantly associated with a lower rate of favorable outcome at day 90 after thrombolysis (OR=0.226，95% CI 0.093-0.547，P=0.001)，whereas AF was not an independent influencing factors for the rate of favorable outcome at day 90 (OR=0.551，95% CI 0.209-1.452，P=0.228). Conclusion AF is irrelevant to short-and longterm prognosis of thrombolysis. Key words: Brain infarction; Atrial fibrillation; Tissue plasminogen activator; Thrombolytic therapy; Prognosis