@article{3106197,
    title = "Early recurrence in paroxysmal versus sustained atrial fibrillation in patients with acute ischaemic stroke",
    author = "Paciaroni, M. and Angelini, F. and Agnelli, G. and Tsivgoulis, G. and Furie, K.L. and Tadi, P. and Becattini, C. and Falocci, N. and Zedde, M. and Abdul-Rahim, A.H. and Lees, K.R. and Alberti, A. and Venti, M. and Acciarresi, M. and Altavilla, R. and D’Amore, C. and Mosconi, M.G. and Cimini, L.A. and Bovi, P. and Carletti, M. and Rigatelli, A. and Cappellari, M. and Putaala, J. and Tomppo, L. and Tatlisumak, T. and Bandini, F. and Marcheselli, S. and Pezzini, A. and Poli, L. and Padovani, A. and Masotti, L. and Vannucchi, V. and Sohn, S.-I. and Lorenzini, G. and Tassi, R. and Guideri, F. and Acampa, M. and Martini, G. and Ntaios, G. and Karagkiozi, E. and Athanasakis, G. and Makaritsis, K. and Vadikolias, K. and Liantinioti, C. and Chondrogianni, M. and Mumoli, N. and Consoli, D. and Galati, F. and Sacco, S. and Carolei, A. and Tiseo, C. and Corea, F. and Ageno, W. and Bellesini, M. and Silvestrelli, G. and Ciccone, A. and Scoditti, U. and Denti, L. and Mancuso, M. and Maccarrone, M. and Orlandi, G. and Giannini, N. and Gialdini, G. and Tassinari, T. and Lodovici, M.L.D. and Bono, G. and Rueckert, C. and Baldi, A. and Toni, D. and Letteri, F. and Giuntini, M. and Lotti, E.M. and Flomin, Y. and Pieroni, A. and Kargiotis, O. and Karapanayiotides, T. and Monaco, S. and Baronello, M.M. and Csiba, L. and Szabó, L. and Chiti, A. and Giorli, E. and Sette, M.D. and Imberti, D. and Zabzuni, D. and Doronin, B. and Volodina, V. and Michel Pd-Mer, P. and Vanacker, P. and Barlinn, K. and Pallesen, L.P. and Kepplinger, J. and Deleu, D. and Melikyan, G. and Ibrahim, F. and Akhtar, N. and Gourbali, V. and Yaghi, S. and Caso, V.",
    journal = "European Stroke Journal",
    year = "2019",
    volume = "4",
    number = "1",
    pages = "55-64",
    publisher = "SAGE Publications Ltd",
    issn = "2396-9873, 2396-9881",
    doi = "10.1177/2396987318785853",
    keywords = "acenocoumarol;  anticoagulant agent;  antihypertensive agent;  antivitamin K;  apixaban;  dabigatran;  rivaroxaban;  warfarin, adult;  aged;  anticoagulant therapy;  Article;  atrial fibrillation;  brain ischemia;  cardioversion;  cerebrovascular accident;  cohort analysis;  computer assisted tomography;  diabetes mellitus;  female;  heart atrium enlargement;  heart failure;  human;  hypertension;  major clinical study;  male;  National Institutes of Health Stroke Scale;  nuclear magnetic resonance imaging;  observational study;  paroxysmal atrial fibrillation;  priority journal;  prospective study;  recurrence risk;  recurrent disease;  revascularization;  risk factor;  sustained atrial fibrillation;  telephone interview;  transient ischemic attack;  treatment outcome",
    abstract = "Background: The relationship between different patterns of atrial fibrillation and early recurrence after an acute ischaemic stroke is unclear. Purpose: In a prospective cohort study, we evaluated the rates of early ischaemic recurrence after an acute ischaemic stroke in patients with paroxysmal atrial fibrillation or sustained atrial fibrillation which included persistent and permanent atrial fibrillation. Methods: In patients with acute ischaemic stroke, atrial fibrillation was categorised as paroxysmal atrial fibrillation or sustained atrial fibrillation. Ischaemic recurrences were the composite of ischaemic stroke, transient ischaemic attack and symptomatic systemic embolism occurring within 90 days from acute index stroke. Results: A total of 2150 patients (1155 females, 53.7%) were enrolled: 930 (43.3%) had paroxysmal atrial fibrillation and 1220 (56.7%) sustained atrial fibrillation. During the 90-day follow-up, 111 ischaemic recurrences were observed in 107 patients: 31 in patients with paroxysmal atrial fibrillation (3.3%) and 76 with sustained atrial fibrillation (6.2%) (hazard ratio (HR) 1.86 (95% CI 1.24–2.81)). Patients with sustained atrial fibrillation were on average older, more likely to have diabetes mellitus, hypertension, history of stroke/ transient ischaemic attack, congestive heart failure, atrial enlargement, high baseline NIHSS-score and implanted pacemaker. After adjustment by Cox proportional hazard model, sustained atrial fibrillation was not associated with early ischaemic recurrences (adjusted HR 1.23 (95% CI 0.74–2.04)). Conclusions: After acute ischaemic stroke, patients with sustained atrial fibrillation had a higher rate of early ischaemic recurrence than patients with paroxysmal atrial fibrillation. After adjustment for relevant risk factors, sustained atrial fibrillation was not associated with a significantly higher risk of recurrence, thus suggesting that the risk profile associated with atrial fibrillation, rather than its pattern, is determinant for recurrence. © European Stroke Organisation 2018."
}