Stroke in patients with secundum atrial septal defect and sequelae after transcatheter closure
| Autor: | Thomas K. Jones, Stephen J. Dolgner, Mark Reisman, Zachary L. Steinberg, Jonathan Buber |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Cardiac Catheterization medicine.medical_specialty Septum secundum Hemodynamics Logistic regression Risk Assessment Heart Septal Defects Atrial Postoperative Complications Risk Factors Internal medicine Prevalence Humans Medicine Cardiac Surgical Procedures Stroke Survival analysis Retrospective Studies business.industry Incidence Incidence (epidemiology) Atrial fibrillation Middle Aged medicine.disease United States Echocardiography Disease Progression Cardiology Population study Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Heart. 107:1875-1880 |
| ISSN: | 1468-201X 1355-6037 |
| DOI: | 10.1136/heartjnl-2021-319050 |
| Popis: | ObjectiveTo evaluate the frequency of and risk factors for stroke as a presenting feature in adult patients with secundum atrial septal defect (ASD); rates of post-closure atrial fibrillation (AF) and stroke were also assessed.MethodsWe retrospectively reviewed adult patients who presented with an ASD between 2002 and 2018, excluding those with known atrial arrhythmias. Risk factors for stroke were identified using multivariable logistic regression. Post-closure stroke was evaluated using survival analysis stratified by the presence of post-procedure AF.ResultsOf 346 patients with ASD (median age 44 years), 34 (10%) presented with a history of stroke. Independent risk factors included elevated body mass index over 25 (OR: 18.2; 95% CI: 4.0 to 82.2; pConclusionsIn this study population, the incidence of stroke prior to ASD closure among patients without atrial arrhythmias was 10%. Risk factors included obesity, smoking and prominent Eustachian valve anatomy. Lifestyle changes should be recommended for at-risk patients, and it may be reasonable to consider ASD closure in the absence of haemodynamic indications in patients at increased risk of stroke. |
| Databáze: | OpenAIRE |
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