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논문 기본 정보

자료유형
학술저널
저자정보
저널정보
대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중학회지 제5권 제2호
발행연도
2003.1
수록면
129 - 135 (7page)

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Background: In clinical practice, some patients with non- valvular atrial fibrillation (NVAF) presented with acute stroke might be considered as a cardioembolic infarction, regardless of the presence of large artery atherosclerosis or small vessel disease. The aims of this study were to elucidate the clinical and pathophysiologic implications of cerebral infarction in the patient with NVAF on the basis of clinical and neuroimaing data. Methods: We reviewed medical records and brain images of consecutive 71 patients with acute ischemic stroke having N VAF registered to Hallym Stroke Registry between Jan. 1999 and Feb. 2002. The risk factor, the pattern of infarcts and concomitant arterial stenosis were analyzed. Results: Smoking (p=0.04) and hyperlipidemia (p=0.02) were more common in control group, who have acute ischemic stroke with normal sinus rhythm and without potential cardioembolic source, than in NVAF group. MCA territory infarct involving cortex was most common. Nine (12.7%) of 71 patients with NVAF were presented with small deep subcortical infarction (SDSCI). Twentyone (35.5%) of severe stenosis (>50%) were noted, and 9 (15.3%) of them were located at the corresponding artery to acute infarct. Conclusions: At present, as any clinical criteria of stroke subtype, is not capable of revealing actual pathophysiologic mechanism, strokes with NVAF may be partly misclassified as cardioembolic infarct even if they caused by concomitant arterial stenosis or small vessel disease. This study suggests that the exact cause of stroke in patient with NVAF be carefully considered before initiating antithrombotic therapy for secondary prevention.

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