Analysis of clinical characteristics of non-valve atrial fibrillation and acute ischemic stroke in the very elderly patients / 中华老年医学杂志

ABSTRACT

Objective To compare the clinical characteristics of patients with non-valve atrial fibrillation(NAVF)and acute ischemic stroke(AIS) between two groupsaged ≥80 years versus 60-79 years.Methods One hundred and five inpatients with NVAF and AIS,treated in Neurological Department Beijing Hospital from November 2009 to November 2014,were divided into two groups of the very elderly patients (≥ 80 years,n =44) and old patients (60-79 years,n =61).Baseline data and clinical characteristics of patients with NAVF and AIS were retrospectively compared between the two groups to explore their risk factors,subtypes of AIS,the complications and prognosis.Results Age was the risk factor for stroke in the very elderly patients with NAVF.Compared with old patients group,the very elderly patients were associated with significantly higher baseline NIHSS(National Institutes of Health Stroke Scale) (11.59 ± 7.76 vs.6.03±7.12,t=3.80,P=0.000).The rates of mRS(modified Rankin Scale)≥3(poorer clinical turnover)1 or more month after AIS was 21.3％ in the old patients versus 56.8％ in the very elderly patients(x2 =13.96,P＜0.01).Moreover,anterior circulation infarction was the main subtypes of AIS in the very elderly patients versus old patients(x2 =12.28,P =0.020).Meanwhile,the very elderly patients versus the old patients had markedly higher rates of complications of AIS,such as pneumonia (65.9％ vs.27.9％;x2 =14.53,P ＜ 0.05),gastrointestinal bleeding(36.4％ vs.13.1％;x2 =7.84,P＜0.05),acute coronary syndrome or heart failure(34.1％ vs.11.5％;x2 =7.89,P＜0.05).Conclusions The very elderly patients versus the old patients show that risk factors for NVAF with AIS are more often the ageing and smoking,and that anterior cerebral circulation is more often affected.The degrees of NVAF and AIS severity are higher,the more complications are found,and the prognosis is worse.