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 Geriatrics- Medicine , Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India for 1 year. The patients of  60 years and above age group were included in the present study 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: the mean age was 72.1 ± 11.21 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 76.45 ± 11.52 vs. 72.06 ± 11.88 years, P = 0.001), had slightly higher CHADS₂VASc score (3.98 vs. 3.62, 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 = 0.27). 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): 7.77, 95% con- fidence interval (CI): 2.99 - 19.03) 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 = 0.04), number of readmissions within 90 days (48% vs. 37%, P = 0.04) 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.