UNRAVELLING ATRIAL FIBRILLATION AETIOLOGY AND ANTICOAGULATION TRENDS IN STROKE. WHERE DO WE STAND? A STUDY FROM NORTHERN PAKISTAN.

BACKGROUND

Atrial Fibrillation is a heart arrhythmia causing stroke and associated with many modifiable risk factors. A number of strokes can be prevented by identifying these risk factors and adopting primary prevention and anticoagulation.

METHODS

This Cross-Sectional observational study on 160 stroke patients; identified frequency and risk factors of Atrial Fibrillation and their prior anticoagulation status. Correlation of risk factors associated with Atrial Fibrillation in stroke was done through Chi Square test.

RESULTS

Among 160 patients, 72 (45%) were males and 88 (55%) females. Mean age was 64.29±13.44SD with range of 31-92 years. Among patients, 113 (70.6%) had ischemic stroke, and 32(20%) had Atrial Fibrillation. Among risk factors, 136(85%) had hypertension, 37(23.1%) had diabetes, 52(32.5%) had ischemic heart disease, 27(16.9%) had valvular heart disease, 9 (5.6%) had hyperthyroidism, 37 (23.1%) had hyperlipidemia, 17(10.6%) had chronic respiratory disease, 19 (11.9%) were smokers, 61(38.1%) had family history of stroke, 12(7.5%) were obese. Only 8 of 32 with AF (25%) had prior anticoagulation. Correlation analysis of risk factors show ischemic heart disease (p=.000285), rheumatic heart disease (p=.000061), hyperlipidemia (p=.0004), chronic respiratory disease (p=.003175) and smoking (p=.00148) as significantly associated with Atrial Fibrillation.

CONCLUSIONS

Ischemic heart disease, hyperlipidemia, smoking and respiratory disease are significant risk factors for stroke in non-valvular atrial fibrillation. All these factors are modifiable so primary prevention and prophylactic anticoagulation should be emphasized.