İhsan Şükrü ŞENGÜN, Kürşad KUTLUK, Gül ERGÖR

Atrial fibrilasyonlu iskemik inme hastalarında inme alt tipleri ve diğer risk faktörleri

Amaç: İskemik inmeli hastalarda atrial fibrilasyonun varlığı halinde genellikle inmenin kardioembolik tipte olduğu düşünülür. Bu hastalara klinik pratikte yaygın olarak antikoagulan tedavi başlanır. Ancak bazı durumlarda, atrial fibrilasyonlu hastalarda görülen iskemik inmelerin kardioembolizme bağlı olduğu kesin olarak ortaya konamaz. Diğer risk faktörlerinin ve başka potansiyel inme mekanizmalarının da iyi değerlendirilmeleri gerekir. Gereç ve Yöntem: Bu çalışmada, serebrovasküler hastalıklar polikliniğimizin inme veri tabanına kayıtlı olan 1509 hasta içinde atrial fıbrilasyonu olanların inme alt tipleri ve diğer risk faktörleri ile olan ilişkileri incelenmiştir. Bulgular: İskemik inme grubundaki hastaların 118'inde (%9,52) atrial fibrilasyon saptandı. Atrial fibrilasyonlu hastalar arasında en. sık görülen inme alt tipinin kardiyoembolik inme (%61) olduğu belirlendi ve bunu sırasıyla aterotrombotik inme (%17), küçük damar hastalığı (%12) ve değerlendirilemeyen grup (%10) izledi. Sonuç: Atrial fibrilasyonlu iskemik inme hastalarında tek mekanizma kardioembolizm değildir. Potansiyel etyolojiııin, diğer risk faktörlerinin ve inme alt tipinin de bu olgularda iyi belirlenmesi gerekir. Antikoagulan tedavi kararında ve warfarin dozunun ayarlanmasında bu heterojen durum etkili olabilir.

Anahtar Kelimeler:

Antikoagülanlar, Atriyal fibrilasyon, Risk faktörleri, Varfarin, Serebrovasküler olay

Stroke subtypes and other risk factors in ischemic stroke patients with atrial fibrillation

Objective: In ischemic stroke patients with atrial fibrillation, anticoagulation therapy is widely used in clinical practice since cardioembolism is thought to be the cause. However, cardioembolism may not be the cause in every case. Other risk factors and potential mechanisms of stroke may also be considered. Material and method: This study has evaluated stroke subtypes in ischemic stroke patients with atrial fibrillation and the relation with other risk factors. Data from the outpatient stroke clinic of 1509 patients has been used and other risk factors. Results: There were 118 cases (9.52%) with atrial fibrillation among ischemic stroke patients. Stroke subtype was mainly cardioembolism in atrial fibrillation group (61%). Other categories were atherothrombotic stroke (17%), small vessel occlusion (12%), and unidentified group (10%) respectively. Conclusion: Cardioembolism is not die only mechanism of ischemic stroke in patients with atrial fibrillation. Determination of potential etiology, other risk factors, and stroke subtype is necessary in these cases since decision of anticoagulation therapy and adjustment of warfarin doses may be affected by this heterogenous condition.

Keywords:

Anticoagulants, Atrial Fibrillation, Risk Factors, Warfarin, Cerebrovascular Accident,

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