Mismanagement of Atrial Fibrillation (AF) as a Modifiable Risk Factor (MRF) for Ischemic Stroke (iStroke) (P1.228)

Objective: To establish differences in the management of AF as a MRF, pre and post iStroke and the relationship with early diagnosis of iStroke. Background: AF is a MRF for iStroke. Anticoagulation is indicated for primary prevention (pre- iStroke) or secondary prevention (post- iStroke). We estimate that our hospitalized elderly patients are more complaint with post- iStroke treatment, and that this therapeutic delay plays a role in the early prognosis of cardioembolic iStroke. Methods: To estimate the frequency of AF, other MRF, iStroke and AF anticoagulation in both pre- and post- iStroke, in our sample representative of hospitalized elderly patients (1523 patients, January/2007-June/2014). To assess the relationship between anticoagulation in AF and early prognosis of iStroke, based on the size of the lesion, death or disability. Results: In our sample, AF and a history of iStroke (20.5[percnt]) were the most common MRF after hypertension (75.9[percnt]) and dyslipidemia (22.4[percnt]), and both were mutually associated (RR:1.7; CI 95[percnt]:1.2-2.3; p<0.001). Most of the patients treated with anticoagulation for known AF had a subtherapeutic RIN value at the time of the iStroke (84.7[percnt]) and did not present other athero-cardioembolic sources at the time of discharge (80[percnt]). The AF-related iStroke was associated with higher mortality (RR:1.9; CI 95[percnt]:1.15-3.3; p<0.001). The indication for anticoagulation for AF increased post-AF related iStroke (58.3[percnt] vs 32[percnt]) and was related to a lower incidence of early disability based on the Rankin scale (F-ANOVA: 4.5; M:3.1±1.5; CI 95[percnt]2.9-3.2;p=0.03). Conclusions: The management of AF improves after the first ischemic event. Anticoagulation in AFis related to a lower incidence of early disability in the setting of iStroke. Disclosure: Dr. Giannaula has received personal compensation for activities with Boehringer Ingelheim. Dr. Sanz has nothing to disclose. Dr. Huerta has nothing to disclose. Dr. Pagano Ajolfi has nothing to disclose. Dr. Malmierca has nothing to disclose. Dr. Alfonso has nothing to disclose.