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Published on: February 26, 2013
Factors Associated with Stroke in Atrial Fibrillation. A Retrospective Study
Ciprian Rachieru1,2,3, Daniel-Florin Lighezan1,3,4, Lucian Petrescu3,5
11Department of Internal Medicine I, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
Insights
In atrial fibrillation (AFi) patients, a higher CHA2DS2-VASc score and reduced left atrial ejection fraction are key predictors of ischemic stroke. Echocardiographic assessment of the left atrium offers new risk stratification insights.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Atrial fibrillation (AFi) is a common arrhythmia associated with an increased risk of ischemic stroke.
- Predictive factors for stroke in AFi patients are crucial for risk stratification and prevention strategies.
Purpose of the Study:
- To retrospectively evaluate known stroke risk factors, such as CHA2DS2-VASc score, and novel factors like left atrial remodeling in patients with AFi.
- To identify new echocardiographic parameters for predicting ischemic stroke in AFi.
Main Methods:
- A retrospective study included 251 patients with AFi, of whom 47 had experienced ischemic stroke.
- Analysis encompassed the CHA2DS2-VASc score and various left atrial remodeling parameters.
Main Results:
- Patients with ischemic stroke were significantly older (over 72.5 years) than those without (OR=2.001, P=0.0367).
- A CHA2DS2-VASc score >4.5 strongly predicted stroke (87.23% vs 12.77%, OR=11.51, P<0.0001).
- Low left atrial ejection fraction (<34.5%) was associated with a higher stroke incidence (61.70% vs 38.30%, OR=2.124, P=0.0238).
Conclusions:
- The CHA2DS2-VASc score remains a valuable tool for predicting ischemic stroke in AFi.
- Echocardiographic parameters, particularly left atrial ejection fraction, serve as novel and effective risk factors for stroke prediction in AFi patients.
Aim:
The aim of our study was to retrospectively evaluate known factors such as CHA2DS2-VASc, but, also, new factors (such as left atrial remodeling), associated with the development of stroke in patients with atrial fibrillation (AFi).
Material And Methods:
We performed a retrospective study in which 251 patients with AFi were included. 47 patients had an ischemic stroke before the diagnosis of AFi, at the time of diagnosis or after AFi was diagnosed. The CHA2DS2-VASc score was analyzed for all patients together with other left atrial remodeling parameters.
Results:
We observed that among the patients with ischemic stroke approximately 61.70% were over 72.5 years old compared to those without stroke who presented this age in a proportion of only 44.61% (OR=2.001, P=0.0367). The CHA2DS2-VASc score had the greatest statistical impact for stroke, as expected. Patients with a CHA2DS2-VASc score >4.5 presented stroke in a proportion of 87.23% compared to CHA2DS2-VASc <4.5 who had stroke only in a proportion of 12.77% (OR=11.51, P=<0.0001). Regarding left atrial remodeling parameters, low LA ejection fraction was associated with a high percentage of stroke among patients (61.70%) compared to those with LA EF>34.5% who had stroke only in a percentage of 38.30% (OR= 2.124, P=0.0238).
Conclusions:
Although the CHA2DS2-VASc score remains a good factor for predicting the association of AFi with ischemic stroke, echocardiographic parameters for the evaluation of the left atrium can be used as new risk factors for predicting the occurrence of ischemic stroke in patients with AFi.
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