Association of Atrial Fibrillation Detected after Stroke with Cardiac Dysfunction and Features of Neurogenic Cardiac Injury
Copyright © 2022 Elsevier Inc. All rights reserved..
OBJECTIVES: Understanding the link between markers of cardiac injury and atrial fibrillation (AF) detected after stroke (AFDAS) may help refine stroke risk stratification and therapeutic approaches in AFDAS.
MATERIALS AND METHODS: We retrospectively analyzed 988 adult patients admitted for acute ischemic stroke and transient ischemic attack, who presented within 4.5 h from last known well. Pertinent clinical variables including features of neurogenic cardiac injury (so-called stroke heart syndrome [SHS]) as well as electrocardiographic and echocardiographic markers of cardiac dysfunction, and AF status (no AF n = 574; known AF n = 311; AFDAS; n = 103) were collected. Multivariable logistic regression was used to determine the independent associations of variables with AFDAS.
RESULTS: A total of 264 (26.7%) subjects fulfilled criteria for SHS. Of these, 174 of had SHS features other than AFDAS (non-AF SHS). Among 677 subjects without known AF, presence of non-AF SHS was associated with a 5-fold odds of AFDAS (OR 5.0, 95%-CI 3.1-8.0, p < 0.001). After adjustment, non-AF SHS (OR 3.2, 95%-CI 1.6-6.4, p = 0.001) and the left atrial volume index (OR 1.04, 95%-CI 1.01-1.08, p = 0.004) remained independently associated with AFDAS.
CONCLUSIONS: The presence of non-AF SHS features and the left atrial volume index were independently associated with AFDAS indicating diverse mechanisms relating to new onset AF. A better understanding of the links between these markers and AFDAS may help uncover potentially modifiable risk factors for AFDAS as well as aid treatment decisions in patients at risk for new onset AF and ischemic stroke.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
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| Enthalten in: |
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association - 31(2022), 6 vom: 05. Juni, Seite 106445 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sun, Yuyao [VerfasserIn] |
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| Links: |
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| Themen: |
Acute stroke |
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| Anmerkungen: |
Date Completed 11.05.2022 Date Revised 11.05.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jstrokecerebrovasdis.2022.106445 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM338700498 |
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| 245 | 1 | 0 | |a Association of Atrial Fibrillation Detected after Stroke with Cardiac Dysfunction and Features of Neurogenic Cardiac Injury |
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| 500 | |a Date Revised 11.05.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVES: Understanding the link between markers of cardiac injury and atrial fibrillation (AF) detected after stroke (AFDAS) may help refine stroke risk stratification and therapeutic approaches in AFDAS | ||
| 520 | |a MATERIALS AND METHODS: We retrospectively analyzed 988 adult patients admitted for acute ischemic stroke and transient ischemic attack, who presented within 4.5 h from last known well. Pertinent clinical variables including features of neurogenic cardiac injury (so-called stroke heart syndrome [SHS]) as well as electrocardiographic and echocardiographic markers of cardiac dysfunction, and AF status (no AF n = 574; known AF n = 311; AFDAS; n = 103) were collected. Multivariable logistic regression was used to determine the independent associations of variables with AFDAS | ||
| 520 | |a RESULTS: A total of 264 (26.7%) subjects fulfilled criteria for SHS. Of these, 174 of had SHS features other than AFDAS (non-AF SHS). Among 677 subjects without known AF, presence of non-AF SHS was associated with a 5-fold odds of AFDAS (OR 5.0, 95%-CI 3.1-8.0, p < 0.001). After adjustment, non-AF SHS (OR 3.2, 95%-CI 1.6-6.4, p = 0.001) and the left atrial volume index (OR 1.04, 95%-CI 1.01-1.08, p = 0.004) remained independently associated with AFDAS | ||
| 520 | |a CONCLUSIONS: The presence of non-AF SHS features and the left atrial volume index were independently associated with AFDAS indicating diverse mechanisms relating to new onset AF. A better understanding of the links between these markers and AFDAS may help uncover potentially modifiable risk factors for AFDAS as well as aid treatment decisions in patients at risk for new onset AF and ischemic stroke | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute stroke | |
| 650 | 4 | |a Atrial fibrillation | |
| 650 | 4 | |a Echocardiogram | |
| 650 | 4 | |a Electrocardiogram | |
| 650 | 4 | |a Stroke heart syndrome | |
| 700 | 1 | |a Miller, Małgorzata M |e verfasserin |4 aut | |
| 700 | 1 | |a Yaghi, Shadi |e verfasserin |4 aut | |
| 700 | 1 | |a Henninger, Nils |e verfasserin |4 aut | |
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