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Differential impact of unrecognised brain infarction on stroke outcome in non-valvular atrial fibrillation.

 Tae Jin Song  ;  Jinkwon Kim  ;  Hye Sun Lee  ;  Chung Mo Nam  ;  Hyo Seok Nam  ;  Eun Hye Kim  ;  Ki Jeong Lee  ;  Dongbeom Song  ;  Ji Hoe Heo  ;  Young Dae Kim 
 THROMBOSIS AND HAEMOSTASIS, Vol.112(6) : 1312-1318, 2014 
Journal Title
Issue Date
Aged ; Aged, 80 and over ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology* ; Cerebral Infarction/diagnosis ; Cerebral Infarction/epidemiology* ; Chi-Square Distribution ; Disability Evaluation ; Female ; Humans ; Linear Models ; Logistic Models ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Predictive Value of Tests ; Prognosis ; Registries ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Stroke/diagnosis ; Stroke/epidemiology* ; Time Factors
Unrecognised brain infarction ; non-valvular atrial fibrillation ; outcome
There has been little information regarding the impact of unrecognised brain infarctions (UBIs) on stroke outcome in patients with non-valvular atrial fibrillation (NVAF). By using volumetric analysis of ischaemic lesions, we evaluated the potential impact of UBIs on clinical outcome according to their presence and categorised type. This study enrolled 631 patients with NVAF having no clinical stroke history. UBIs were categorised into three types as territorial, lacunar, or subcortical. We collected stroke severity, functional outcome at three months, and the total volume of UBIs and acute infarction lesions. We investigated the association between clinical outcome and the type or volume of UBI, using a linear mixed model and logistic regression analysis. UBIs were detected in 285 (45.2 %) patients; territorial UBIs were observed in 24.4 % of patients (154/631), lacunar UBIs in 25 % (158/631), and subcortical UBIs in 15.7 % (99/631). Although initial stroke severity was not different between patients with UBIs and those without, those with UBIs had less improvement during hospitalisation, leading to poorer outcome at three months. Among the three types of UBIs, only territorial UBIs were associated with poor outcome, especially in patients with relatively smaller acute infarction volume. UBIs, in particular, territorial UBIs, may be considered as predictors for poor outcome after ischaemic stroke in patients with NVAF. Our results suggest that the impact of UBIs on clinical outcome differs according to the type of UBIs and the acute stroke severity.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Kim, Eun Hye(김은혜)
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Song, Dong Beom(송동범)
Lee, Ki Jeong(이기정)
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
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