[Atrial fibrillation and carotid artery disease in ischemic stroke patients].

Ischemic strokes occurring in patients with non-rheumatic atrial fibrillation (AF) are due to a variety mechanisms, and not necessarily to cardiogenic embolism. The aim of the study was to determine the role and prevalence of carotid artery disease in stroke patients with AF, as well as its influence on the stroke prognosis. 513 consecutive patients with ischemic stroke participated in the study. The diagnosis was based on the clinical examination, brain CT and Doppler ultrasonography. Risk factors and clinical data were collected prospectively according to the Stroke Data Bank NIH protocol. AF was diagnosed in 166 (32.4%) patients. Carotid artery stenosis > 45% was present in 104 (20.3%). AF and co-existing carotid stenosis was found in 27 (5.3%) cases. There were 16.2% patients with carotid stenosis in the group with AF. In all groups 87 patients died (30-day mortality rate: 17%). The highest mortality rate was noted in the group with co-existing AF and carotid artery stenosis (25.9%), followed by the groups with AF only (21.6%) and no changes (15.9%), with the lowest mortality in the group with only vascular changes, i.e. stenosis or occlusion (9.1%). The carotid stenosis group differed significantly both from patients with co-existing AF and carotid stenosis (p > 0.01) and from those with AF only (p < 0.05).