Outcome of men and women after atrial fibrillation and stroke

Objectives: Atrial fibrillation (AF) is a well-known risk factor for ischaemic stroke. The aim was to examine long-term outcome of men and women after stroke related to AF.

Methods: Patients with AF and ischaemic stroke were followed up 1 year and 5 years after stroke. Level of dependence (Barthel Index), disability (modified Rankin Scale), risk factors, mortality and stroke prophylaxis before and after stroke were analysed. All parameters were compared between men and women.

Results: From a cohort of 597 stroke patients during a one-year period, 155 patients (94 women/61 men) with stroke related to AF were included. Women were older than men at stroke onset and more men had a history of smoking and diabetes, but there was no difference in stroke severity. Only 111 patients had been diagnosed with AF before stroke. After 1 year 78 patients (45 women/33 men) and after 5 years 35 patients (21 women/14 men) were followed up. There was no difference in mortality after 5 years with 76% women and 73% men deceased. Half of both genders were independent 1 year after stroke, and after 5 years, approximately a third among women, but half of the men, were independent. Women were less frequently treated with warfarin before stroke (11% vs 28%), but warfarin and NOAC treatment had increased among both women and men at hospital discharge.

Conclusions: There were no gender differences in long-term mortality after stroke related to AF. Men were significantly more often prescribed anticoagulants before stroke, a finding that indicates the need for further studies.