Atrial fibrillation is associated with poor long-term outcome after mechanical thrombectomy for anterior large vessel occlusion stroke

Objectives: Atrial fibrillation (AF) is one of the leading causes of acute ischemic stroke (AIS). The aim of our study was to determine the influence of AF on the long-term outcome of patients with AIS due to anterior circulation large vessel occlusion (LVO) treated with mechanical thrombectomy (MT). Methods: Our study included 127 consecutive patients with AIS due to anterior LVO who underwent MT between January 2018 and March 2020. Demographics, clinical, radiological and treatment characteristics were prospectively collected. Modified Rankin scale (mRS) score <2 was defined as a good functional outcome. Results: AF was detected in 62 (48.8%) patients. Patients with AF were elder (73.1 +/- 8.7 vs. 58.5 +/- 14.2 years, p<0.01) and usually female (56.5% vs. 36.9%, p=0.03). They had a lower percentage of good functional outcome (31.6% vs. 62.3%, p<0.01) and a higher mortality rate (47.5% vs. 18.5%, p<0.01) after one year of follow-up. In the multivariate logistic regression the variables that showed significance with p <0.05 in previous univari-ate analyses were included. The presence of AF (aOR 0.29, 95% CI 0.11-0.78, p=0.01) and initial NIHSS score >15 (aOR 0.25, 95% CI 0.11-0.56, p<0.01) were independent negative predictors of good functional outcome after one year of fol-low-up. However, the presence of AF did not affect all-cause mortality within one year (p=0.18). Conclusion: AF and initial NIHSS score >15 are independent negative predictors of good long-term functional outcome in patients with AIS due to ante-rior circulation LVO treated with MT.

Automated summary

The aim of this study was to determine the influence of atrial fibrillation (AF) on the long-term outcome of patients with acute ischemic stroke (AIS) due to anterior circulation large vessel occlusion (LVO) treated with mechanical thrombectomy (MT). The results showed that AF was associated with a lower percentage of good functional outcome and a higher mortality rate after one year of follow-up.