Table 4.
Outcomes in meta-analyses following endovascular thrombectomy 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 |
|---|---|---|---|---|---|---|
| Kobeissi et al. [107] | 6131 | 2305 (37.60%) | Meta-analysis | No significant difference in the odds of functional independence (90-day mRS ≤ 2) between patients with AF and those without AF (OR 0.72 [95% CI 0.47–1.10], p = 0.13). Confounders were not adjusted for. However, following sensitivity analysis, the rate of functional independence was significantly lower for AF patients (OR 0.65 [95% CI 0.52–0.81], p < 0.001). |
Mortality was significantly higher in patients with AF (OR 1.47 [95% CI 1.12–1.92], p = 0.005). | No significant difference in the odds of sICH between AF patients compared to non-AF patients (OR 1.05 [95% CI 0.84–1.31], p = 0.68). |
| Patel & Bhaskar [122] | 21,148 | 8857 (41.88%) a | Meta-analysis | There was no significant association between AF and favourable functional outcomes (90-day mRS ≤ 2) following EVT (OR 0.826 [95% CI 0.651–1.049], p = 0.117). | There was no significant association between AF and sICH following EVT (OR 0.982 [95% CI 0.815–1.184], p = 0.851). | There was no significant association between AF and 90-day mortality at post-EVT (OR 1.236 [95% CI 0.969–1.578], p = 0.088). |
| Smaal et al. [104] | 1351 | 447 (33.09%) | Meta-analysis | After adjusting for other factors, there was no significant association between favourable functional outcomes (90-day mRS ≤ 2) and AF status (aOR 1.14 [95% CI 0.87–1.51], p = 0.337). | There was no significant association between AF and 90-day mortality (aOR 1.14 [95% CI 0.83–1.57], p = 0.410). | There was no significant association between AF and sICH (aOR 0.57 [95% CI 0.3–1.07], p = 0.082). |
Abbreviations: AF = atrial fibrillation, sICH = symptomatic intracerebral haemorrhage, EVT = endovascular thrombectomy, IVT = intravenous thrombolysis, OR = odds ratio, aOR = adjusted odds ratio, CI = confidence interval, mRS = Modified Rankin Scale. a This value refers to the crude prevalence of AF. Notably, the meta-analysis by Patel and Bhaskar [122] included some studies that had data on the prevalence of AF post-EVT but not on the impact of AF on clinical outcomes, so the number of patients with data on outcomes following EVT was lower than the total number of patients.