Burden of Premature Atrial Complexes and Risk of Recurrent Stroke and Death in Patients with Mild to Moderate Ischemic Stroke.

Autor: Sejr MH; Cardiovascular Research Unit, Department of Cardiology, Regional Hospital West Jutland, Herning, Denmark. Electronic address: michhers@rm.dk., May O; Cardiovascular Research Unit, Department of Cardiology, Regional Hospital West Jutland, Herning, Denmark., Damgaard D; Department of Neurology, Aarhus University Hospital, Aarhus, Denmark., Bruun NH; Department of Public Health, Biostatistical Advisory Service (BIAS), Aarhus University, Aarhus, Denmark., Nielsen JC; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
Jazyk: angličtina
Zdroj: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2020 Feb; Vol. 29 (2), pp. 104490. Date of Electronic Publication: 2019 Dec 12.
DOI: 10.1016/j.jstrokecerebrovasdis.2019.104490
Abstrakt: Background: Premature atrial complexes (PACs) meet increased attention as a potential intermediary between sinus rhythm and atrial fibrillation (AF). Patients with even high numbers of PACs do not fulfill current guidelines for oral anticoagulation treatment though an associated stroke risk is suspected.
Objective: We aimed to determine whether a high number of PACs or runs of AF less than 30 seconds in 2-day continuous electrocardiogram (ECG) recording was associated with risk of recurrent ischemic stroke/transient ischemic attack (TIA) or death in a large cohort of patients with acute ischemic stroke or TIA and no prior AF.
Methods: We performed 48 hours continuous ECG recording within 1 week after ischemic stroke/TIA. PACs were reported as mean number of PACs per hour. Patients were followed in Danish Stroke Registry, Danish Civil Registration System, and Danish National Patient Registry. Cox Regression analysis was used to calculate hazard ratios.
Results: We included 1507 patients with TIA (40%) or ischemic stroke (60%), of which 98.7% had mild to moderate strokes. Mean age was 72.9 (7.8) years, 43.4% were females. Follow-up was 2.3 (1.3) years. Hazard ratio for recurrent stroke/TIA or death did not differ between quartiles of PAC burden, nor did any of the 2 components of this composite endpoint. Nonsustained AF less than 30 seconds was not associated with higher risk of recurrent stroke/TIA or death.
Conclusions: In a large cohort of patients with recent ischemic stroke or TIA, burden of PACs or nonsustained AF less than 30 seconds were not associated to higher risk of recurrent stroke/TIA or death.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: