{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T16:37:08Z","timestamp":1792859828307,"version":"4.5.0"},"reference-count":42,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Neurol"],"abstract":"<jats:p>Introduction: Preclinical studies have demonstrated that dexmedetomidine (DEX), a sedative widely used in intensive care units (ICU), exerts neuroprotective effects. However, its potential protective role and underlying mechanisms in ischemic stroke patients with atrial fibrillation (IS-AF) remain unclear. The study\u02bcs objective was to assess the connection between the early administration of DEX and short-term mortality from all causes in patients with IS-AF. Methods: From the MIMIC-IV database, patients with IS-AF were identified, including those who were administered DEX and those who were not. The primary endpoint was 7-day all-cause mortality, and the secondary endpoint was 90-day all-cause mortality. Propensity score matching (PSM) was utilized to ensure baseline covariates were balanced. Cox proportional hazards models and Kaplan-Meier survival curves and were utilized to evaluate the association between DEX use and mortality, with subgroup analyses conducted to ensure the findings\u02bc robustness. Results: In total, 1,355 patients with IS-AF participated, with 253 (18.7%) receiving DEX. After PSM, 208 pairs were matched. In the fully adjusted model, DEX administration was significantly associated with lower all-cause mortality compared with the control group at both 7 days (before PSM, HR = 0.36, 95% CI: 0.19\u20130.68, p = 0.002; after PSM, HR = 0.26, 95% CI: 0.12\u20130.54, p &lt; 0.001) and 90 days (before PSM, HR = 0.84, 95% CI: 0.66\u20131.07, p = 0.162; after PSM, HR = 0.72, 95% CI: 0.53\u20130.97, p = 0.031). The subgroup analyses revealed that DEX\u02bcs protective effect was stronger in patients aged 70 and above, females, those with hypertension, and those without heart failure or chronic kidney disease. Kaplan-Meier survival curves consistently illustrated that DEX users had greater survival probabilities both before and after matching. Conclusion: In patients with IS-AF, DEX administration is connected to decreased all-cause mortality mortality, underlining the possible importance of DEX in ICU settings.<\/jats:p>","DOI":"10.1159\/ene\/acsag008","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:19:42Z","timestamp":1789672782000},"page":"1-1","source":"Crossref","is-referenced-by-count":0,"title":["Dexmedetomidine Use and Short-Term All-Cause Mortality in Intensive Care Unit Patients with Ischemic Stroke and Atrial Fibrillation: A Propensity-Matched Analysis from 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