Chronic kidney disease is independently associated with acute recurrent cerebral infarct in patients with atrial fibrillation

J Clin Neurosci. 2017 Jun:40:97-101. doi: 10.1016/j.jocn.2017.02.013. Epub 2017 Mar 9.

Abstract

Background and purpose: The present study aimed to determine the frequency and time of recurrent cerebral infarct (RCI) in patients with acute ischemic stroke (AIS) and atrial fibrillation (AF), and to clarify associated factors.

Methods: We retrospectively assessed and compared the clinical features of 79 consecutive patients (male, n=56; median age, 75y; median baseline NIHSS, 4) who were hospitalized due to AIS accompanied by AF, and who did or did not develop RCI between January 2012 and March 2015.

Results: Direct oral anticoagulants were administered to 59% of the patients after a median of two days from the onset of the index stroke. Stroke recurred in 10 (13%) of the 79 patients about 5days after admission. The proportion of men was lower (30% vs. 77%, P=0.005) and the patients were older (82vs. 75y, P=0.049) in the group with RCI. Chronic kidney disease was significantly more prevalent in the group with RCI (50% vs. 16%, P=0.025) and independently associated with RCI (OR, 6.59; 95%CI, 1.19-36.63; P=0.031).

Conclusions: We found that RCI frequently develops about 5days after admission in patients with AIS and AF and that chronic kidney disease is independently associated with RCI.

Keywords: Acute ischemic stroke; Atrial fibrillation; Chronic kidney disease; Recurrence.

MeSH terms

  • Aged
  • Anticoagulants / administration & dosage
  • Anticoagulants / therapeutic use
  • Atrial Fibrillation / complications*
  • Atrial Fibrillation / diagnosis
  • Cerebral Infarction / complications
  • Cerebral Infarction / diagnosis
  • Cerebral Infarction / drug therapy
  • Cerebral Infarction / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / etiology

Substances

  • Anticoagulants