Endovascular treatment for acute ischemic stroke in patients with versus without atrial fibrillation: a matched-control study
Authors: Tong Xu , Li Shijing , Liu Wei , Ren Zeguang , Liu Raynald , Jia Baixue , Zhang Xuelei , Huo Xiaochuan , Luo Gang , Ma Gaoting , Wang Anxin , Wang Yilong , Wang Yongjun , Miao Zhongrong , Mo Dapeng ,   on behalf of ANGEL-ACT study group, Miao Zhongrong , Gui Liqiang , Song Cunfeng , Peng Ya , Wu Jin , Zhao Shijun , Zhao Junfeng , Zhou Zhiming , Li Yongli , Jing Ping , Yang Lei , Liu Yajie , Zhao Qingshi , Liu Yan , Peng Xiaoxiang , Gao Qingchun , Guo Zaiyu , Chen Wenhuo , Li Weirong , Cheng Xiaojiang , Xu Yun , Zhang Yongqiang , Zhang Guilian , Lu Yijiu , Lu Xinyu , Wang Dengxiang , Wang Yan , Li Hao , Hua Yang , Geng Deqin , Yuan Haicheng , Wang Hongwei , Yang Haihua , Wang Zengwu , Wei Liping , Liufu Xuancong , Shi Xiangqun , Li Juntao , Yang Wenwu , Jing Wenji , Yong Xiang , Wang Leyuan , Li Chunlei , Cao Yibin , Zhu Qingfeng , Zhang Peng , Luo Xiang , Chen Shengli , Peng Wen Wu , Wang Lixin , Wen Xue , Shi Shugui , Wang Wanming , Bo Wang , Yuan Pu , Wang Dong , Guan Haitao , Liang Wenbao , Ma Daliang , Chen Long , Xiao Yan , Xie Xiangdong , Shi Zhonghua , Zeng Xiangjun , Su Fanfan , Chang Ming Ze , Yin Jijun , Sun Hongxia , Li Chong , Bi Yong , Xie Gang , Zhao Yuwu , Wang Chao , Zhang Peng , Wang Xianjun , Li Dongqun , Liang Hui , Chen Zhonglun , Wang Yan , Wang Yuxin , Yin Lin , Qiu Hong Kai , Wei Jun , Sun Yaxuan , Feng Xiaoya , Wu Weihua , Gao Lianbo , Ai Zhibing , Tan Lan , Ding Li , Liang Qilong , Wang Zhimin , Yang Jianwen , Xu Ping , Dong Wei , Zheng Quanle , Zhu Zhenyun , Zhao Liyue , Meng Qingbo , Wei Yuqing , Chen Xianglin , Wang Wei , Sun Dong , Yan Yongxing , Yuan Guangxiong , Yang Yadong , Zhou Jianfeng , Yang Zhi , Zhang Zhenzhong , Guan Ning , Wang Huihong 
Published: September 2021

Abstract
Background and objective
The effect of atrial fibrillation (AF) on outcomes of endovascular treatment (EVT) for acute ischemic stroke (AIS) is controversial. This study aimed to investigate the association of AF with outcomes after EVT in AIS patients.

Methods
Subjects were selected from ANGEL-ACT registry (Endovascular Treatment Key Technique and Emergency Work Flow Improvement of Acute Ischemic Stroke) - a prospective consecutive cohort of AIS patients undergoing EVT at 111 hospitals in China between November 2017 and March 2019, and then grouped according to having a history of AF or not. After 1:1 propensity score matching, the outcome measures including the 90-day modified Rankin Scale (mRS) score, successful recanalization after final attempt, symptomatic intracranial hemorrhage (ICH) within 24 h, and death within 90 days were compared.

Results
A total of 1755 patients, 550 with AF and 1205 without AF, were included. Among 407 pairs of patients identified after matching, no significant differences were found in the mRS score (median: 3 vs. 3 points; P = 0.29), successful recanalization (87.2 vs. 85.3%; P = 0.42), symptomatic ICH (9. 4 vs. 9.1%; P = 0.86) and death (16.3 vs. 18.4%; P = 0.44) between patients with and without AF.

Conclusion
The findings of this matched-control study show comparable outcomes of EVT in Chinese AIS patients with and without AF, which do not support withholding EVT in patients with both AIS and AF.

Trial registration
NCT03370939
First registration date: 28/09/2017
First posted date: 13/12/2017