Duration of device-detected subclinical atrial fibrillation and occurrence of stroke in ASSERT
| Autor: | Isabelle C. Van Gelder, Anne H Hobbelt, Carlos A. Morillo, Jeff S. Healey, Stuart J. Connolly, Jia Wang, Stefan H. Hohnloser, Harry J.G.M. Crijns, Alessandro Capucci, Michiel Rienstra, Chu-Pak Lau, Michael R. Gold |
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| Přispěvatelé: | Cardiovascular Centre (CVC), MUMC+: MA Cardiologie (9), RS: CARIM - R2.01 - Clinical atrial fibrillation, Cardiologie |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
PROGNOSIS PROGRESSION 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine law Internal medicine EMBOLIC EVENTS medicine COHORT 030212 general & internal medicine Stroke Subclinical infection RISK business.industry Proportional hazards model MORTALITY Hazard ratio Atrial fibrillation medicine.disease TEMPORAL RELATIONSHIP Confidence interval Embolism REGISTRY Cardiology Artificial cardiac pacemaker TRIAL RHYTHM Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal, 38(17), 1339-1344. Oxford University Press |
| ISSN: | 0195-668X |
| Popis: | Background ASSERT demonstrated that subclinical atrial fibrillation (SCAF) is common in pacemaker patients without prior AF and is associated with increased risk of ischemic stroke or systemic embolism. SCAF episodes vary in duration and little is known about the incidence of different durations of SCAF, or their prognosis. Methods and results ASSERT followed 2580 patients receiving a pacemaker or ICD, aged >65 years with hypertension, without prior AF. The effect of SCAF duration on subsequent risk of ischemic stroke or embolism was evaluated with time-dependent covariate Cox models. Patients in whom the longest SCAF was ≤6 min were excluded from the analysis (n=125). Among 2455 patients during mean follow-up of 2.5 years, the longest single episode of SCAF lasted >6 min to 6 h in 462 patients (18.8%), >6–24 h in 169 (6.9%), and >24 h in 262 (10.7%). SCAF duration >24 h was associated with a significant increased risk of subsequent stroke or systemic embolism (adjusted hazard ratio [HR] 3.24, 95% confidence interval [CI] 1.51–6.95, P=0.003). The risk of ischemic stroke or systemic embolism in patients with SCAF between 6 min and 24 h was not significantly different from patients without SCAF. Conclusions SCAF >24 h is associated with an increased risk of ischemic stroke or systemic embolism. |
| Databáze: | OpenAIRE |
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