Objective: Atrial fibrillation (AF) is an important risk factor for ischemic stroke, with a high morbidity and mortality ratios. Diabetes mellitus (DM) was reported as a strong and independent risk factor for both the occurrence of AF and ischemic stroke. In this context, here we investigated the influence of diabetes mellitus on the recurrence of ischemic stroke in patients with atrial fibrillation.

Material and Method: In this retrospective cohort study, we reviewed the files of 2798 patients with stroke followed in our cerebrovascular outpatient clinics for 15 years.

Results: A total of 313 patients (11.2%) with ischemic stroke had atrial fibrillation. Of these, 152 patients on regular follow-up were included; mean duration of follow-up was 94.6±52.2 (median, 34) months. The mean age of the study population was 70.0±10.3 years, and 54.3% were females (83 patients). Diabetes mellitus was present in 28.3% (43 patients). The mean TTR (time in therapeutic range) calculated for INR was 56.6±35.5% (median, 58%). Sixteen patients (10.5%) had a recurrent ischemic stroke. The presence of diabetes mellitus was very significantly associated with the re-occurrence of ischemic stroke in patients with AF (p=0.012), with an Odds ratio of 4.2 (1.4-12.7). TTR for serum fasting glucose levels was also significantly associated with recurrent ischemic stroke (p=0.011). TTR calculated for HbA1c (p=0.354) or for INR (p=0.106) did not show a significant association.

Conclusion: The presence of diabetes mellitus and serum fasting glucose levels seems to be the most important and independent risk factors for recurrent ischemic stroke in patients with AF.

Atrial fibrillation Ischemic stroke Diabetes mellitus