Were associated with infarct volumes. However, factors other than INR levels PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/20460822 that affect stroke phenotypes are largely unknown. Therefore, we evaluated the determinants of stroke phenotypes (pattern and volume) among patients with AF who were not adequately anticoagulated. Methods: We analyzed data pertaining to consecutive AF patients admitted over a 6-year period with acute MCA territory infarcts. We divided the patients according PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/13485127 to DWI (diffusion-weighted imaging) lesion volumes and patterns, and the relationship between stroke predictors (the CHADS2 and CHA2DS2-VASc score), systemic, and local factors and each stroke phenotype were then evaluated. Results: The stroke phenotypes varied among 231 patients (admission INR median 1.06, interquartile range (IQR) 1.00-1.14). Specifically, (1) the DWI lesion volumes ranged from 0.04-338.62 ml (median 11.86 ml; IQR, 3.07-44.20 ml) and (2) 46 patients had a territorial infarct pattern, 118 had a lobar/deep pattern and 67 had a small scattered pattern. Multivariate testing revealed that the CHADS2 and CHA2DS2-VASc score were not related to either stroke phenotype. Additionally, the prior use of antiplatelet agents was not related to the stroke phenotypes. Congestive heart failure and diastolic dysfunction were not associated with stroke phenotypes. Conclusions: The results of this study indicated that the determinants of stroke phenotypes were different from the predictors (i.e., CHADS2 and CHA2DS2-VASc score) of stroke in patients with AF.Background Atrial fibrillation (AF) affects 3 to 5 of the population older than 65 years of age [1] and is a leading cause of fatal ischemic stroke [2,3]. Stroke in patients with AF is generally more severe and the outcome is markedly poorer than in patients with sinus rhythm [4]. Adjusted-dose warfarin is highly effective ( 60 reduction), and aspirin is modestly effective ( 20 reduction) for the prevention of stroke in AF [5,6]. Moreover, international normalized ratio (INR) levels at the time of stroke were recently reported to be associated with infarct volumes [7].* Correspondence: nmboy@unitel.co.kr Department of Neurology, Stroke and Cerebrovascular Centre, Samsung Medical Centre, Sungkyunkwan University, South KoreaHowever, the factors affecting stroke phenotypes are unknown among AF patients. Several studies have suggested that infarct patterns are better delineated by DWI than other imaging modalities, are correlated with the underlying stroke pathogenic mechanism,[8,9] and are associated with stroke outcome [10]. In addition, the infarct pattern on DWI may differ depending on the characteristics (type and nature) 3-(tert-Butyldimethylsilyloxy)propan-1-amine of clots [11-13]. Risk factors for stroke (the CHADS 2 and CHA 2 DS 2 -VASc score) and systemic (D-dimer and C-reactive protein) and local (left ventricular ejection fractions) factors may be associated with stroke phenotype. AF is associated with higher levels of prothrombotic factors, endothelial dysfunction, and markers of platelet activation [12,14,15].?2011 Oh et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Oh et al. BMC Neurology 3-Bromo-5-chloro-2-fluoroaniline 2011, 11:107 http://www.biomedcentral.com/1471-2377/11/Page 2 ofThe formation of left atrial appendage thrombi in AF is influenced by several hem.