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. 2025 Jan;32(1):e16555.
doi: 10.1111/ene.16555. Epub 2024 Nov 28.

Atrial fibrillation in young stroke patients: Associated factors and outcomes in a nationwide analysis

Affiliations

Atrial fibrillation in young stroke patients: Associated factors and outcomes in a nationwide analysis

Tania Garrido-Hernández et al. Eur J Neurol. 2025 Jan.

Abstract

Background and purpose: Knowledge about the prevalence of atrial fibrillation (AF) in young stroke patients, as well as its associated factors and outcomes, is scarce. Our objective was to analyse it.

Methods: A retrospective analysis of the Spain Nationwide Minimum Basic Data Set (MBDS) (2016-2020), including ischaemic stroke (IS) patients aged 18 and 50 years, was conducted. Multivariate analyses were conducted to identify factors related to AF diagnosis.

Results: Amongst 11,615 young IS patients, 426 (3.7%) had AF. Patients with AF were older (median age 45, interquartile range 42-48 vs. 44, interquartile range 40-47 years, p < 0.001) and displayed more incapacitating symptoms, higher in-hospital complications and were less often discharged home (p < 0.001). Multivariate analyses showed that older age (odds ratio [OR] 1.053, 95% confidence interval [CI] 1.032-1.074), obstructive sleep apnoea (OR 1.508, 95% CI 1.018-2.233), hyperthyroidism (OR 3.741, 95% CI 1.798-7.783), valvular heart disease (OR 6.094, 95% CI 4.261-8.716), congenital (OR 2.386, 95% CI 1.146-4.969) and non-congenital (OR 4.446, 95% CI 3.149-6.278) cardiopathies and heart failure (OR 3.098, 95% CI 1.905-5.037) were independently associated with higher probability of AF, whereas female gender (OR 0.647, 95% CI 0.516-0.812), diabetes mellitus (0.487, 95% CI 0.339-0.699), smoking (OR 0.617, 95% CI 0.501-0.759), patent foramen ovale (OR 0.210, 95% CI 0.111-0.396) and arterial dissection (OR 0.294, 95% CI 0.130-0.668) were associated with a lower probability.

Conclusions: In young IS patients, AF is associated with more in-hospital complications and disabling strokes. These findings emphasize the need to recognize AF in this demographic group, especially in patients with risk factors like hyperthyroidism and cardiomyopathies. Clinicians should assess these risk factors to ensure timely diagnosis and management of AF.

Keywords: atrial fibrillation; outcome; risk factors; stroke; young.

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Conflict of interest statement

The authors declare no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

FIGURE 1
FIGURE 1
Flowchart of the patient selection.
FIGURE 2
FIGURE 2
Type of cardiomyopathies according to the diagnosis of atrial fibrillation. The bar chart represents the percentage of cardiomyopathies according to the presence of atrial fibrillation. The table shows the absolute numbers and percentages of cardiopathies as well as the p value for the differences between the group with atrial fibrillation and the group without atrial fibrillation.

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