Non Rheumatic Atrial Fibrillation as Risk of Stroke

Abstract

Atrial fibrillation (AF) is one of the main risk factor for ischemic stroke. The reason for an increased stroke risk in AF has always been claimed to be the occurrence of left atrial thrombosis causing arterial embolism. In patients with Rheumatic heart disease especially mitral valve stenosis with AF, the frequency of atrial thrombosis has found to be 30 - 42% (Keren G et al. 1987), and the prevalence of left atrial thrombosis in NRAF are higher than in control 13-27% (Petersen P et al. 1988). Objectives: We investigated if there are any differences in risk factors or atherosclerotic manifestations between ischemic brain infarction patients with and without AF? Are the brain lesions characteristics in these patients similar?Patients and Methods: This is a case- control study of 26 patients with acute ischemic stroke and NRAF (case subjects) a and 26 patients with acute ischemic stroke and sinus rhythm. (control subjects). The patients admitted to the hospital; the diagnosis of cerebral infarction was confirmed by new CT of the brain. All the participants underwent the standard examination and testing as well as ECG and ECHO. Result: Patient with NRAF had higher mortality 30% than in control (SR) 7% (P<0.001). NRAF patients had positive brain CT finding 68% compared to 23% of the SR Patients (P<0.001). Conclusion: Brain infarction in non-Rheumatic AF group are more serious than other and therefor make up a (high risk) group for which acute treatment would be specially indicated and primary prophylaxis with anticoagulants might therefore be considered.