So, you've described a bad problem but DID NOTHING to solve it. WHAT THE FUCK ARE YOU DOING IN STROKE RESEARCH ANYWAY? Let better people actually solve stroke. I'd fire you all!
Poor collateral flow with severe hypoperfusion explains worse outcome in acute stroke patients with atrial fibrillation
Abstract
Background:
Atrial
fibrillation (AF) is associated with poorer functional outcomes in
acute stroke patients. It has been hypothesized that this is due to poor
collateral recruitment.
Aims:
This study aimed to investigate the relationship between AF and collaterals with outcome in thrombectomy patients.
Methods:
This
retrospective cohort study identified 1036 acute ischemic patients from
the INternational Stroke Perfusion Imaging REgistry. The cohort was
divided into two groups: 432 with AF and 604 without AF. Patients were
stratified by collateral grades as good, moderate, and poor. Within each
collateral grade, the prediction of AF versus No AF for good outcome
(3-month modified Rankin Scale of 0–2) was determined. Then, within each
collateral grade, perfusion was compared between those with and without
AF.
Results:
AF
was negatively associated with good outcome in patients with poor
collaterals (26.7% vs 51.2% for AF vs No AF, odds ratio = 0.32 (95%
confidence interval = 0.22–0.50), p < 0.001), but not in patients
with good (50.9% vs 58.1% for AF vs No AF, odds ratio = 0.75
(0.46–1.23), p = 0.249) or moderate collaterals (43.6% vs 50.9% for AF
vs No AF, odds ratio = 0.75 (0.47–1.18), p = 0.214). AF was associated
with severe hypoperfusion only in patients with poor collateral flow
(54.0 vs 35.5 mL for AF vs No AF, p < 0.001).
Conclusions:
AF-related stroke is associated with more severe hypoperfusion and worse outcome in those with poor collaterals.
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