Affiliation:
1. Department of Rehabilitation, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang,
China
Abstract
Background:
The association between atrial fibrillation (AF) and the prognosis of intravenous
thrombolysis (IVT) in patients with Acute Ischemic Stroke (AIS) is debated. Hypokalemia
is highly prevalent in patients with AF. We aimed to investigate the effect of hypokalemia and AF
on the prognosis of AIS patients following IVT.
Method:
AIS patients undergoing IVT were enrolled and divided into four groups: normokalemia
and non-AF, normokalemia and AF, hypokalemia and non-AF, hypokalemia and AF. Logistic regression
was applied to analyze the impact of hypokalemia, AF, and their combination on the prognosis
of patients.
Results:
The analysis included 567 patients, 184 with 3-month poor prognosis (modified Rankin
Scale score of 3-6). Following adjustment of risk factors, hypokalemia and AF increased the risks
for 3-month poor prognosis (adjusted Odds Ratios (aOR) = 4.97; 95% confidence interval (CI),
1.99-12.44, P =.001), early neurological deterioration (END) (aOR=7.98; 95% CI, 3.55-17.95, P
<.001), 1-year poor prognosis (aOR=5.05; 95% CI, 1.99-12.81, P =.001), 1-year all-cause death
(aOR =6.95; 95% CI, 2.35-20.56, P <.001). Patients with normokalemia and AF merely increased
the risk of 1-year all-cause death (aOR=2.69; 95% CI, 1.10-6.61, P=.013). Patients with hypokalemia
and non-AF were not associated with any poor prognosis. There were combined and interactive
effects of hypokalemia with AF on the 3-month poor prognosis (P for interaction =.039)
and END (P for interaction=.005).
Conclusion:
Hypokalemia and AF synergistically increased the risk of near-term poor prognosis,
END, long-term poor prognosis, and all-cause death of AIS patients following IVT.
Publisher
Bentham Science Publishers Ltd.
Subject
Cellular and Molecular Neuroscience,Developmental Neuroscience,Neurology