Clinical features, risk factors and survival in cardiac myxoma-related ischemic stroke: A multicenter case-control
Man-Li Qiao1, Lin Ma2, Chao-Bin Wang3
1Department of General Practice Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Insights
Cardiac myxoma (CM) is a key cause of stroke in young adults. Narrower tumors, high mobility, surface thrombus, and lower BNP levels predict CM-related ischemic stroke (CM-IS), which surgery effectively treats.
Area of Science:
- Cardiology
- Neurology
- Oncology
Background:
- Cardiac myxoma (CM) is a significant cause of ischemic stroke (IS) in young adults.
- Limited and conflicting studies exist on CM-related ischemic stroke (CM-IS).
- This study investigates CM-IS clinical features, risk factors, and outcomes post-surgery.
Purpose of the Study:
- To characterize clinical presentations of CM-IS.
- To identify risk factors associated with CM-IS development.
- To evaluate short-term survival rates after surgical resection of CM in CM-IS patients.
Main Methods:
- Retrospective analysis of CM patients from three referral centers.
- Inclusion of 402 patients (54 CM-IS, 348 Non-stroke).
- Multivariate analysis to determine risk factors for CM-IS.
Main Results:
- CM-IS patients presented with neurological, cardiac, and constitutional symptoms.
- Risk factors for CM-IS included tumor width < 30 mm, high tumor mobility, surface thrombus, and lower BNP levels.
- Three-year survival rate post-surgery for CM-IS patients was 95.7%.
Conclusions:
- CM-IS patients typically experience mild to moderate neurological deficits.
- Tumor width, mobility, surface thrombus, and BNP levels are potential CM-IS predictors.
- Surgical resection of cardiac myxoma is a safe and effective treatment for CM-IS.
Background:
Cardiac myxoma (CM) is an important etiology of stroke in young adults, but studies on CM-related ischemic stroke (CM-IS) are limited and conflicting. Hence, we investigated clinical characterizations, risk factors of CM-IS, and short-term survival after surgical resection.
Methods:
We performed a retrospective analysis of data from all CM patients at three referral management centers and conducted follow-up examination.
Results:
Among 414 CM patients, 402 were recruited for further analysis, including 54 patients with CM-IS and 348 patients with CM without stroke (Non-stroke). In the acute phase, patients presented with NIHSS 3 (interquartile range: 0-10) and clinical presentation comprising neurological, cardiac and constitutional symptoms. Multivariate analysis showed that the factors associated with an increased risk of CM-IS were tumor width < 30 mm [OR = 2.652, 95% CI: 1.061-6.627, P = 0.037], tumors with high-mobility (OR = 2.700, 95% CI: 1.357-5.371, P = 0.005), thrombus on the tumor surface (OR = 1.856, 95% CI: 1.003-3.434, P = 0.049), and lower B-type natriuretic peptide (BNP) levels (OR = 0.995, 95% CI: 0.989-0.999, P = 0.047). The overall three-year survival rate was 95.7% (95% CI: 94.9-96.5) in CM-IS patients who underwent surgery.
Conclusions:
CM-IS patients had mild or moderate neurologic deficits with various presentations at disease onset. Narrower tumor width, tumors with high-mobility, thrombus on the tumor surface, and lower BNP levels are potential predictors of CM-IS development. Surgical removal of CM is safe and efficacious in patients with CM-IS.
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