Abstract WP256: Atrial Fibrillation Predicting Factors in Transient and Minor Stroke Patients

Introduction and Purpose: Our aim was to review the characteristics of transient ischemic attack (TIA) and minor ischemic stroke patients monitored for atrial fibrillation (AF) epidoses detection within the first 4weeks after stroke to assess AF predictors. Materials and Methods: TIA and minor ischemic stroke patients (nihss≤ 5) were selected from CRYPTO-AF database. CRYPTO-AF is a prospective multicentre registry of patients with cryptogenic stroke older of 55 year-old. Monitoring started within the first 72 hours from stroke symptoms onset and was prolonged for 4 weeks. Clinical, cardiographic and blood test parameters of patients included were reviewed. Fisher exact and Mann Whitney tests were used to analyze categorical and continuous data. Results: In our cohort of 152 transient and minor ischemic stroke patients, 55.9% were men, mean age 73.18±10.24 and median NIHSS score was 2.31(0-5). A total of 30 patients (20.3%) were diagnosed with AF in the first month of monitoring, 6 patients (5.7%) within the first 3 days, 14 patients (13.3%) between 3 days and to 2 weeks of monitoring, and 14 partientes (12.4%) between the second and the fourth week. In these transient and minor ischemic stroke patients, age (p< 0.031), left atrial volume index (p< 0.023), the appearance of isolated extrasystoles during monitoring (p< 0.021), Type B natriuretic peptide (p< 0.011) and the longitudinal strain (p< 0.019) appeared as independet precitors of AF. However in the multivariate analysis adjusted for the above variables, only left atrial strain (OR 0.89, 95% CI: 0.797-0.991, p< 0.034) independently predicts AF detection. Conclusions: In our serie, only the left atrial strain appeared as a indepent predictor of AF. Given the known pathophysiology of TIA and minor ischemic stroke, the description of AF predictors would help to identify those patients who would benefit from completing a longer monitoring. More studies are needed to identify these predictors.

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ASSOCIATION BETWEEN LEFT ATRIAL STRAIN AND SUBCLINICAL ATRIAL FIBRILLATION IN PATIENTS WITH CRYPTOGENIC STROKE: THE SURPRISE ECHO SUBSTUDY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(19)32227-2 ◽

2019 ◽

Vol 73 (9) ◽

pp. 1621

Author(s):

Flemming Javier Olsen ◽

Louisa M. Christensen ◽

Derk W. Krieger ◽

Søren Højberg ◽

Nis B. Høst ◽

...

Keyword(s):

Atrial Fibrillation ◽

Left Atrial ◽

Cryptogenic Stroke ◽

Left Atrial Strain ◽

Atrial Strain

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Relationship between left atrial strain, diastolic dysfunction and subclinical atrial fibrillation in patients with cryptogenic stroke: the SURPRISE echo substudy

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-019-01700-y ◽

2019 ◽

Vol 36 (1) ◽

pp. 79-89 ◽

Cited By ~ 1

Author(s):

Flemming J. Olsen ◽

Louisa M. Christensen ◽

Derk W. Krieger ◽

Søren Højberg ◽

Nis Høst ◽

...

Keyword(s):

Atrial Fibrillation ◽

Diastolic Dysfunction ◽

Left Atrial ◽

Cryptogenic Stroke ◽

Left Atrial Strain ◽

Atrial Strain

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Abstract W MP65: Moderate to Severe Left Atrial Enlargement is Associated with Cardioembolic or Cryptogenic Stroke Recurrence in a Multiethnic Cohort: The Northern Manhattan Study

Stroke ◽

10.1161/str.46.suppl_1.wmp65 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Shadi Yaghi ◽

Yeseon P Moon ◽

Consuelo Mora-McLaughlin ◽

Joshua Z Willey ◽

Marco R Di Tullio ◽

...

Keyword(s):

Atrial Fibrillation ◽

Ischemic Stroke ◽

Left Atrial ◽

Recurrent Stroke ◽

Cryptogenic Stroke ◽

Cardioembolic Stroke ◽

Stroke Recurrence ◽

Stroke Patients ◽

Stroke Subtypes ◽

Multiethnic Cohort

Background: While left atrial (LA) enlargement increases incident stroke risk, the association with recurrent stroke is unclear. Our aim was to determine the association of LA enlargement (LAE) with stroke recurrence risk and recurrent stroke subtypes likely related to embolism (cryptogenic or cardioembolic). Methods: We enrolled 655 first ischemic stroke patients in the Northern Manhattan Stroke Study. LA size was measured by two-dimensional echocardiogram as part of the clinical evaluation and patients were followed annually for up to 5 years. LA size adjusted for sex and body surface area was categorized into three groups: normal (52.7%), mild LAE (31.6%), and moderate to severe LAE (15.7%). The outcomes were total recurrent stroke, and recurrent combined cryptogenic or cardioembolic stroke. Cox proportional hazard models assessed the association between LA size and risk of stroke recurrence. Results: Of 655 patients, LA size data was present in 529 (81%). Mean age was 69 ± 13 years; 46% were male and 18% had atrial fibrillation. Over a median of 4 years, recurrent stroke occurred in 83 patients (16%), 29 were cardioembolic or cryptogenic stroke. After adjusting for baseline demographics and risk factors including atrial fibrillation and congestive heart failure, compared to normal LA size, moderate to severe LAE was associated with greater risk of recurrent combined cardioembolic or cryptogenic stroke (adjusted HR 2. 99, 95% CI 1. 10 to 8.13), but not with risk of total stroke recurrence (adjusted HR 1.18, 95% CI 0.60 to 2.32). Mild LAE was not associated with either total stroke recurrence or the combined recurrent cryptogenic or cardioembolic stroke subtypes. Conclusion: Moderate to severe LAE is an independent marker of recurrent cardioembolic or cryptogenic stroke in a multiethnic cohort of ischemic stroke patients. Future research is needed to determine if anticoagulant use reduces the risk of recurrence in ischemic stroke patients with moderate to severe LAE.

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