Clinical and Therapeutic Aspects of Ischemic Stroke in Atrial Fibrillation at the Neurology Department of CHU Conakry

Abstract

Introduction: The main cause of ischemic stroke in our setting is atrial fibrillation. The aim of this study was to evaluate the clinical and therapeutic aspects of atrial fibrillation during ischemic stroke.

Material and Methods: We conducted a retrospective descriptive study lasting one year from November 1, 2020 to November 31, 2021, involving all patients with ischemic stroke diagnosed by CT or MRI. We included patients with atrial fibrillation confirmed by a 12-lead électrocardiogrammes (ECG) or a 24- hour ECG holter. Thromboembolic risk was assessed by the CHA2DS2Vasc score and bleeding risk by the HAS-BLED score.

Results: A total of 1,400 patients (19.64%) were enrolled. Mean age was 57.3 +/-16.64 years, predominantly female (54.5%), with hypertension as a risk factor (45.09%). The mean NIHSS score was 17.9 +/-3.2, associated with disorders of consciousness (44.36%) and hemiplegia (100%). atrial fibrillation was persistent in 54.90% of cases. A CHA2DS2-VASc score ≥ 2 was found in 94.9% of cases, and a low HAS-BLED score in 73% of cases, for whom Rivaroxaban was the first-line treatment in 76.72% of cases.

Conclusion: This study has shown that atrial fibrillation is common in cardioembolic cerebral infarctions with age and hypertension as risk factors.