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Association between excessive premature atrial complexes and cryptogenic stroke: results of a case-control study

Jithin K Sajeev1,2, Anoop N Koshy1, Helen Dewey1,3

  • 1Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia.

BMJ Open
|August 3, 2019
PubMed

Insights

Excessive premature atrial complexes (PACs) are linked to cryptogenic stroke, suggesting they may indicate atrial myopathy. This finding could aid in developing new stroke prevention strategies.

Area of Science:

  • Cardiology
  • Neurology
  • Clinical Medicine

Background:

  • Anticoagulation trials for cryptogenic stroke have shown mixed results.
  • There is a need for reliable markers of atrial myopathy to predict stroke risk.
  • Premature atrial complexes (PACs) are being investigated as a potential indicator.

Purpose of the Study:

  • To investigate the association between excessive premature atrial complexes (PACs) and ischemic stroke, including cryptogenic stroke.
  • To explore the relationship between PACs and common vascular risk factors.

Main Methods:

  • A case-control study involving 461 ischemic stroke/TIA patients and age-matched controls.
  • 24-hour Holter monitoring was used to assess PAC burden (≥200 PACs/24 hours).
  • Multivariate regression analysis was employed to identify independent risk factors.

Main Results:

  • Excessive PACs were found in 25.6% of stroke/TIA patients versus 14.7% of controls (p<0.01).
  • Independent risk factors for ischemic stroke/TIA included excessive PACs (OR 1.97), smoking (OR 1.58), and hypertension (OR 1.53).
  • Excessive PACs were the strongest independent risk factor for cryptogenic stroke (OR 1.95).

Conclusions:

  • Excessive PACs are independently associated with cryptogenic stroke.
  • PACs may serve as a reproducible marker for atrial myopathy.
  • Further prospective studies are needed to evaluate PACs in stroke prevention strategies.
Abstract

Keywords:
cardiologystroke medicine

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