Prevalence of atrial fibrillation in intracerebral hemorrhage. (12th June 2013)

• Record Type: Journal Article
• Authors: Horstmann, S.; Rizos, T.; Jenetzky, E.; Gumbinger, C.; Hacke, W.; Veltkamp, R.
• Is Part Of: European journal of neurology. Volume 21:Number 4(2014:Apr.)
• Page Start: 570
• Page End: 576
• Publication Date: 2013-06-12
• Subjects: Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.12215
• Languages: English
• ISSNs: 1351-5101

Abstract

<abstract abstract-type="main" id="ene12215-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ene12215-sec-0001" sec-type="section"> <title>Background and purpose</title> <p>Oral anticoagulation (OAC) is an effective preventive therapy for ischemic stroke in atrial fibrillation (AF). The management of anticoagulation in AF patients with previous intracerebral hemorrhage (ICH) is challenging. The aim of this study was to determine the prevalence of AF after acute ICH in a consecutive monocenter cohort, and to document the subsequent management with respect to OAC.</p> </sec> <sec id="ene12215-sec-0002" sec-type="section"> <title>Methods</title> <p>Consecutive patients with spontaneous ICH were prospectively included within 19 months. Diagnosis of AF was based on medical history, 12‐lead electrocardiogram (ECG), 24‐h and continuous ECG monitoring. CHADS<sub>2</sub> scores and patient medication were recorded at admission and after 3 months. Additionally, after 3 months mortality, the management of anticoagulation and a newly detected AF were assessed.</p> </sec> <sec id="ene12215-sec-0003" sec-type="section"> <title>Results</title> <p>In total, 206 ICH patients were eligible for data analysis. After 3 months, AF had been diagnosed in 64/206 ICH patients (31.1%). Mortality after 3 months was higher in patients with AF in univariate analysis (45.3% vs. 31.0%). After adjusting for comorbidities and OAC use, AF did not remain an independent predictor for mortality. In total, 35 patients with AF survived 3 months. Of these, CHADS<sub>2</sub> score was 2 (2/3, median, interquartile range (IQR)) and 27/35 patients had an indication for OAC with respect to the CHADS<sub>2</sub> score, but only 25.7% had been (re‐)started on OAC. No consistent factors for deciding whether to initiate OAC treatment could be identified.</p> </sec> <sec id="ene12215-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Atrial fibrillation is a frequent comorbidity in patients suffering an ICH. Our findings underline the prevailing uncertainty regarding the anticoagulation management of AF after ICH.</p> </sec> </abstract>