Objective:

To assess the effect of pertinent co-morbidities and imaging findings on functional outcomes in patients with Atrial fibrillation (AF) taking oral anticoagulation (OAC) therapy who developed acute ischemic stroke (AIS).

Background:

Per current guidelines, most patients with AF are treated with OACs. However, these patients can still develop AIS. Exploring the underlying factors associated with worse functional outcomes is crucial.

Design/Methods:

We retrospectively reviewed 33 adult patients with AF on long-term OACs presenting with AIS. Information collected included demographic variables, medical history, and pertinent clinical and imaging parameters. A series of logistic regression models adjusted for age, gender, hypertension, diabetes, hyperlipidemia, and LVO were run to analyze the association of these parameters with AIS outcomes, assessed as binarized modified Rankin scale score (mRSS) (4-6: worse outcome vs 0-3: better outcome [ref]) and binarized NIH stroke scale (NIHSS) (>15: worse outcome vs 0-15: better outcome [ref]) at discharge. All analyses were conducted using SAS Studio OnDemand for Academics (SAS Institute Inc., Cary, NC).

Results:

Among 33 patients (mean age 74 + 13.6 years, 51.5% males) assessed for binarized mRSS, presence of LVO showed 21.1 times the odds of a poor outcome (OR: 21.1, 95% CI: 1.68, 265.27, p=0.02). When assessed for NIHSS at discharge, presence of LVO showed 3.82 times the odds of a poor outcome (OR: 3.82, 95% CI: 0.37, 39.03, p=0.26). When assessed for binarized mRSS outcome, hyperlipidemia showed 9.87 times the odds of a poor outcome (OR: 9.87, 95% CI: 0.9, 108.13, p=0.06). When assessed for binarized NIHSS at discharge, hyperlipidemia showed 18.4 times the odds of a poor outcome (OR: 18.4, 95% CI: 1.3, 261.28, p=0.03).

Conclusions:

Our analysis revealed significant associations between the presence of LVO and worse mRSS at discharge and between HLD and worse NIHSS at discharge. However, further research is needed by employing matched controls.