Table 3.
Outcomes in meta-analyses following intravenous thrombolysis in ischemic stroke patients with atrial fibrillation.
| Study | Number of Patients (n) |
Number of Patients with AF and AF Prevalence (%) |
Study Design |
Functional Outcomes | Mortality | sICH |
|---|---|---|---|---|---|---|
| Hu & Ji [110] | 8509 | 2125 (24.97%) | Meta- analysis |
AF patients reported significantly lower odds of favourable functional outcomes (90-day mRS ≤ 2) following IVT compared to non-AF patients (OR 0.55 [95% CI 0.43–0.70], p < 0.001). Comparing AF patients who received IVT with AF patients who did not, there was no significant difference in the odds of favourable functional outcomes (OR 1.37 [95% CI 0.72–2.60, p = 0.331). |
AF patients reported significantly higher odds of mortality following IVT compared to non-AF patients (OR 2.05 [95% CI 1.79–2.36], p < 0.001). Comparing AF patients who received IVT with AF patients who did not, there was no significant difference in mortality (OR 0.95 [95% CI 0.63–1.44], p = 0.813). |
AF patients reported significantly higher odds of sICH compared to non-AF patients (OR 3.44 [95% CI 2.04–5.82], p < 0.001). The odds of sICH were significantly higher in AF patients receiving IVT compared to AF patients not receiving IVT (OR 3.44 [95% CI 2.04–5.82], p < 0.001). |
| Yue et al. [118] | 14,801 | 3432 (23.19%) | Meta- analysis |
AF patients were significantly less likely to experience favourable outcomes (90-day mRS ≤ 2) following IVT (OR 1.95 [95% CI 1.33–2.85], p = 0.001). | AF patients had significantly higher odds of mortality 90 days following IVT (OR 2.13 [95% CI 1.68–2.70], p < 0.001). | The odds of sICH were significantly higher amongst AF patients (OR 1.28 [95% CI 1.08–1.52], p = 0.006). |
| Patel & Bhaskar [122] | 39,650 | 11,163 (28.15%) a | Meta-analysis | AF patients had significantly lowers odds of favourable functional outcomes (90-day mRS ≤ 2) at 90 days following IVT (OR 0.512 [95% CI 0.376–0.696], p < 0.001) | AF was associated with significantly higher odds of sICH following IVT (OR 1.690 [95% CI 1.400–2.039], p = 0.851). | AF was associated with significantly higher odds of 90-day mortality following IVT (OR 1.799 [95% CI 1.218–2.657], p = 0.003) |
Abbreviations: AF = atrial fibrillation, IVT = intravenous thrombolysis, sICH = symptomatic intracerebral haemorrhage, mRS = modified Rankin Scale, OR = odds ratio, CI = confidence interval, NIHSS = National Institute of Health Stroke Scale. a This value refers to the crude prevalence of AF. Notably, the meta-analysis by Patel & Bhaskar [122] included some studies that had data on the prevalence of AF post-IVT but not on the impact of AF on clinical outcomes, so the number of patients with data on outcomes following IVT was lower than the total number of patients.