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European Heart Journal Advance Access originally published online on March 11, 2005
European Heart Journal 2005 26(8):848; doi:10.1093/eurheartj/ehi210
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions{at}oupjournals.org

Comment on stroke with atrial fibrillation: data from the Austrian stroke registry: reply

Christina Steger

II Medical Department
Krankenanstalt Rudolfstiftung
Steingasse 31/18
A-1030 Vienna
Austria

Jörg Slany

II Medical Department
Krankenanstalt Rudolfstiftung
Steingasse 31/18
A-1030 Vienna
Austria

Claudia Stöllberger

II Medical Department
Krankenanstalt Rudolfstiftung
Steingasse 31/18
A-1030 Vienna
Austria
Tel: +43 1 713 98 70
Fax: +43 1 711 65/2209
E-mail address: claudia.stoellberger{at}chello.at

We agree with Dr Ivanusa M. and Dr Ivanusa Z. that the management of acute stroke is an important factor for the outcome of stroke patients, depending on the pre-hospital care, emergency team, departments where stroke patients are treated, and the level of education of physicians and nurses concerned with stroke patients.1

The aim of our study was to assess the care of acute stroke patients exclusively in departments for internal medicine, as it is indicated in the Abstract and in the Methods sections.2 These patients were treated by specialists for internal medicine. Twelve per cent of patients with atrial fibrillation (AF) and nine per cent of patients without AF were transferred to intensive care units and were treated there by specialists for intensive care medicine. We did not evaluate in how many cases a neurologist was additionally consulted. Nevertheless, mortality and outcome of patients in our study were quite comparable to patients treated on specialized stroke units.3

We emphasize the importance of early cerebral computed tomography (CCT), because immediate CCT was shown to improve survival and quality of life after stroke.4 In our study, 95% of patients with AF and 96% without AF had a CCT, 4% with AF and 10% without AF were examined by magnetic resonance imaging.

References

  1. Fulgham JR, Ingall TJ, Stead LG, Cloft HJ, Wijdicks EF, Flemming KD. Management of acute ischemic stroke. Mayo Clin Proc 2004;79: 1459–1469.[ISI][Medline]
  2. Steger C, Pratter A, Martinek-Bregel M, Avanzini M, Valentin A, Slany J, Stöllberger C. Stroke patients with atrial fibrillation have a worse prognosis than patients without: data from the Austrian Stroke registry. Eur Heart J 2004;25:1734–1740.[Abstract/Free Full Text]
  3. Jørgensen HS, Nakayama H, Reith J, Raaschou HO, Olsen TS. Acute stroke with atrial fibrillation. The Copenhagen stroke study. Stroke 1996;10:1765–1769.
  4. Wardlaw JM, Seymour J, Cairns J, Keir S, Lewis S, Sandercock P. Immediate computed tomography scanning of acute stroke is cost-effective and improves quality of life. Stroke 2004;35:2477–2483.[Abstract/Free Full Text]

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This Article
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