European Journal of Molecular & Clinical Medicine

Abstract

Aim:To determine theIncidence of Acute Ischemic Stroke in Hospitalized Patients With Atrial Fibrillation Who Had Anticoagulation Interruption.
Methods: A retrospective study was conducted in the Department of Consultant Physician and Cardiologist, ARC Hospital, Bhagalpur, Bihar,  India for 1 year. We included patients 18 years or older who were admitted to the hospital with a primary or secondary diagnosis of AF who had anticoagulation interruption without heparin bridge vs. non-interrupted group.
Results: A total of 450 patients were included in the study. In this cohort, mean age was 71.1 ± 10.21 years and 50.89% were female. A total of 50 patients out of 450 (11.11%) had anticoagulation interruption in more than 48 h (median interruption of 67 h). Compared to non-interruption group, patients with anticoagulation interruption were older (mean age 75.45 ± 10.52 vs. 71.06 ± 10.88 years, P = 0.001), had slightly higher CHADS₂VASc score (3.88 vs. 3.52, P = 0.01), more likely to have heart failure and less likely to have HTN. Only 10 patients out of 450 (2.22%) had acute ischemic stroke during their hospital stay: 2 patient (4%) in the anticoagulation interruption group, and 8 patients (2%) in the non-interruption group. There was no statistically significant difference in incidence of ischemic stroke between the two groups (1.31% vs. 0.27%, P = 0.21). Short-term interruption of anticoagulation was not associated with a significant increased risk of in-hospital ischemic stroke. CHA₂DS₂VASc score was an independent strong predictor of in-hospital stroke (odds ratio (OR): 7.67, 95% confidence interval (CI): 2.89 - 18.03) In terms of secondary outcomes in anticoagulation interruption versus non-interruption groups, results were as follows: mortality (0 vs. 0.68%, P = 1), bleeding (4% vs. 1%, P = 0.03), number of readmissions within 90 days (48% vs. 37%, P = 0.03) and average LOS (7.74 vs. 2.75 days, P < 0.0001).
Conclusion: The patients with AF the incidence of ischemic stroke during hospitalization is low and did not significantly increase with short-term interruption of anticoagulation. The incidence of ischemic stroke in hospitalized patients with AF is strongly correlated with CHA₂DS₂VASc score.