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Effect of atrial fibrillation on outcomes after mechanical thrombectomy and long-term ischemic recurrence in patients with acute basilar artery occlusion
INTRODUCTION: According to the literature on anterior circulation, comorbid atrial fibrillation (AF) is not associated with a worse functional outcome, lower reperfusion rates, or higher rates of intracranial hemorrhage after mechanical thrombectomy (MT) compared to intravenous thrombolysis (IVT) or...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9372365/ https://www.ncbi.nlm.nih.gov/pubmed/35968276 http://dx.doi.org/10.3389/fneur.2022.909677 |
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author | Zhao, Chenhao Luo, Weidong Liu, Xing Luo, Jun Song, Jiaxing Yuan, Junjie Liu, Shuai Huang, Jiacheng Kong, Weilin Hu, Jinrong Yang, Jie Sun, Ruidi Yue, Chengsong Xie, Dongjing Li, Linyu Sang, Hongfei Qiu, Zhongming Li, Fengli Wu, Deping Zi, Wenjie Yang, Qingwu |
author_facet | Zhao, Chenhao Luo, Weidong Liu, Xing Luo, Jun Song, Jiaxing Yuan, Junjie Liu, Shuai Huang, Jiacheng Kong, Weilin Hu, Jinrong Yang, Jie Sun, Ruidi Yue, Chengsong Xie, Dongjing Li, Linyu Sang, Hongfei Qiu, Zhongming Li, Fengli Wu, Deping Zi, Wenjie Yang, Qingwu |
author_sort | Zhao, Chenhao |
collection | PubMed |
description | INTRODUCTION: According to the literature on anterior circulation, comorbid atrial fibrillation (AF) is not associated with a worse functional outcome, lower reperfusion rates, or higher rates of intracranial hemorrhage after mechanical thrombectomy (MT) compared to intravenous thrombolysis (IVT) or treatment with supportive care. However, data are limited for the effect of comorbid AF on procedural and clinical outcomes of acute basilar artery occlusion (ABAO) after MT. This study aimed to investigate the effect of atrial fibrillation on outcomes after MT and long-term ischemic recurrence in patients with ABAO. METHODS: We performed a registered study of the Endovascular Treatment for Acute Basilar Artery Occlusion Study (BASILAR, which is registered in the Chinese Clinical Trial Registry, http://www.chictr.org.cn; ChiCTR1800014759) from January 2014 to May 2019, which included 647 patients who underwent MT for ABAO, 136 of whom had comorbid AF. Prospectively defined baseline characteristics, procedural outcomes, and clinical outcomes were reported and compared. RESULTS: On multivariate analysis, AF predicted a shorter puncture-to-recanalization time, higher first-pass effect rate, and lower incidence of angioplasty and/or stenting (p < 0.01). AF had no effect on intracranial hemorrhage incidence [adjusted odds ratio (aOR), 1.093; 95% confidence interval (CI), 0.451–2.652], 90-day functional outcomes (adjusted common odds ratio, 0.915; 95% CI, 0.588–1.424), or mortality (aOR, 0.851; 95% CI, 0.491–1.475) after MT. The main findings were robust in the subgroup and 1-year follow-up analyses. Comorbid AF was the remaining predictor of ischemic recurrence (aOR, 4.076; 95% CI, 1.137–14.612). CONCLUSIONS: The study revealed no significant difference in the safety and efficacy of MT for ABAO regardless of whether patients had comorbid AF. However, a higher proportion of patients with AF experienced ischemic recurrence within 1 year after MT. |
format | Online Article Text |
id | pubmed-9372365 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-93723652022-08-13 Effect of atrial fibrillation on outcomes after mechanical thrombectomy and long-term ischemic recurrence in patients with acute basilar artery occlusion Zhao, Chenhao Luo, Weidong Liu, Xing Luo, Jun Song, Jiaxing Yuan, Junjie Liu, Shuai Huang, Jiacheng Kong, Weilin Hu, Jinrong Yang, Jie Sun, Ruidi Yue, Chengsong Xie, Dongjing Li, Linyu Sang, Hongfei Qiu, Zhongming Li, Fengli Wu, Deping Zi, Wenjie Yang, Qingwu Front Neurol Neurology INTRODUCTION: According to the literature on anterior circulation, comorbid atrial fibrillation (AF) is not associated with a worse functional outcome, lower reperfusion rates, or higher rates of intracranial hemorrhage after mechanical thrombectomy (MT) compared to intravenous thrombolysis (IVT) or treatment with supportive care. However, data are limited for the effect of comorbid AF on procedural and clinical outcomes of acute basilar artery occlusion (ABAO) after MT. This study aimed to investigate the effect of atrial fibrillation on outcomes after MT and long-term ischemic recurrence in patients with ABAO. METHODS: We performed a registered study of the Endovascular Treatment for Acute Basilar Artery Occlusion Study (BASILAR, which is registered in the Chinese Clinical Trial Registry, http://www.chictr.org.cn; ChiCTR1800014759) from January 2014 to May 2019, which included 647 patients who underwent MT for ABAO, 136 of whom had comorbid AF. Prospectively defined baseline characteristics, procedural outcomes, and clinical outcomes were reported and compared. RESULTS: On multivariate analysis, AF predicted a shorter puncture-to-recanalization time, higher first-pass effect rate, and lower incidence of angioplasty and/or stenting (p < 0.01). AF had no effect on intracranial hemorrhage incidence [adjusted odds ratio (aOR), 1.093; 95% confidence interval (CI), 0.451–2.652], 90-day functional outcomes (adjusted common odds ratio, 0.915; 95% CI, 0.588–1.424), or mortality (aOR, 0.851; 95% CI, 0.491–1.475) after MT. The main findings were robust in the subgroup and 1-year follow-up analyses. Comorbid AF was the remaining predictor of ischemic recurrence (aOR, 4.076; 95% CI, 1.137–14.612). CONCLUSIONS: The study revealed no significant difference in the safety and efficacy of MT for ABAO regardless of whether patients had comorbid AF. However, a higher proportion of patients with AF experienced ischemic recurrence within 1 year after MT. Frontiers Media S.A. 2022-07-29 /pmc/articles/PMC9372365/ /pubmed/35968276 http://dx.doi.org/10.3389/fneur.2022.909677 Text en Copyright © 2022 Zhao, Luo, Liu, Luo, Song, Yuan, Liu, Huang, Kong, Hu, Yang, Sun, Yue, Xie, Li, Sang, Qiu, Li, Wu, Zi and Yang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Zhao, Chenhao Luo, Weidong Liu, Xing Luo, Jun Song, Jiaxing Yuan, Junjie Liu, Shuai Huang, Jiacheng Kong, Weilin Hu, Jinrong Yang, Jie Sun, Ruidi Yue, Chengsong Xie, Dongjing Li, Linyu Sang, Hongfei Qiu, Zhongming Li, Fengli Wu, Deping Zi, Wenjie Yang, Qingwu Effect of atrial fibrillation on outcomes after mechanical thrombectomy and long-term ischemic recurrence in patients with acute basilar artery occlusion |
title | Effect of atrial fibrillation on outcomes after mechanical thrombectomy and long-term ischemic recurrence in patients with acute basilar artery occlusion |
title_full | Effect of atrial fibrillation on outcomes after mechanical thrombectomy and long-term ischemic recurrence in patients with acute basilar artery occlusion |
title_fullStr | Effect of atrial fibrillation on outcomes after mechanical thrombectomy and long-term ischemic recurrence in patients with acute basilar artery occlusion |
title_full_unstemmed | Effect of atrial fibrillation on outcomes after mechanical thrombectomy and long-term ischemic recurrence in patients with acute basilar artery occlusion |
title_short | Effect of atrial fibrillation on outcomes after mechanical thrombectomy and long-term ischemic recurrence in patients with acute basilar artery occlusion |
title_sort | effect of atrial fibrillation on outcomes after mechanical thrombectomy and long-term ischemic recurrence in patients with acute basilar artery occlusion |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9372365/ https://www.ncbi.nlm.nih.gov/pubmed/35968276 http://dx.doi.org/10.3389/fneur.2022.909677 |
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