How is Ambulatory Electrocardiogram Predictive of Stroke in Atrial Fibrillation Patients?
Background. Atrial fibrillation (AF) is a significant stroke risk factor. Further research is needed to clarify whether higher atrial fibrillation burden (AFB) link to the elevated risk of ischemic embolism, and how AF burden could combine with CHA2DS2-VASc score to improve the anticoagulation strat...
Saved in:
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-01-01
|
| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2022/7619669 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849395406115438592 |
|---|---|
| author | Xiuping Zhuo Meinv Huang |
| author_facet | Xiuping Zhuo Meinv Huang |
| author_sort | Xiuping Zhuo |
| collection | DOAJ |
| description | Background. Atrial fibrillation (AF) is a significant stroke risk factor. Further research is needed to clarify whether higher atrial fibrillation burden (AFB) link to the elevated risk of ischemic embolism, and how AF burden could combine with CHA2DS2-VASc score to improve the anticoagulation strategy. We aim to evaluate if the AF burden characterized using 24-hours Holter ECG monitoring is associated with the risk of ischemic stroke. Methods. This cohort study enrolled 210 Holter ECG monitoring detected atrial fibrillation patients. The burden of atrial fibrillation was defined as the percentage of time in atrial fibrillation during the monitoring period, and the AF burden and CHA2DS2-VASc score were compared between patients with and without thromboembolic outcomes. Multivariate regressions were conducted to estimate the predictors of thromboembolic outcomes. Results. Eighteen thromboembolic events occurred within a median follow-up of 11.39 months. Patients with ischemic stroke had higher CHA2DS2-VASc scores but not higher AF burden. After adjusting for age, hypertension, diabetes, anticoagulation, antithrombotic therapy, AF burden, and AF with higher CHA2DS2-VASc score was associated with increased risk for ischemic stroke (hazard ratio (HR), 15.17). CHA2DS2-VASc score > 4.5 was a predictor of significantly higher risk of future stroke (AUC 0.92). Conclusions. In Holter ECG monitoring detected AF, AF burden does not significantly impact the subsequent risk of stroke; whereas, CHA2DS2-VASc scoring is still a robust predictor of stroke risk. This may illustrate that once AF is detected from Holter ECG monitoring, underlying risk factors appear to be more predictive of subsequent stroke risk than atrial fibrillation burden. |
| format | Article |
| id | doaj-art-aaf4356c59b44902a8e8ab7dd0db88e2 |
| institution | Kabale University |
| issn | 2090-0597 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-aaf4356c59b44902a8e8ab7dd0db88e22025-08-20T03:39:37ZengWileyCardiology Research and Practice2090-05972022-01-01202210.1155/2022/7619669How is Ambulatory Electrocardiogram Predictive of Stroke in Atrial Fibrillation Patients?Xiuping Zhuo0Meinv Huang1Affiliated Hospital of Putian UniversityAffiliated Hospital of Putian UniversityBackground. Atrial fibrillation (AF) is a significant stroke risk factor. Further research is needed to clarify whether higher atrial fibrillation burden (AFB) link to the elevated risk of ischemic embolism, and how AF burden could combine with CHA2DS2-VASc score to improve the anticoagulation strategy. We aim to evaluate if the AF burden characterized using 24-hours Holter ECG monitoring is associated with the risk of ischemic stroke. Methods. This cohort study enrolled 210 Holter ECG monitoring detected atrial fibrillation patients. The burden of atrial fibrillation was defined as the percentage of time in atrial fibrillation during the monitoring period, and the AF burden and CHA2DS2-VASc score were compared between patients with and without thromboembolic outcomes. Multivariate regressions were conducted to estimate the predictors of thromboembolic outcomes. Results. Eighteen thromboembolic events occurred within a median follow-up of 11.39 months. Patients with ischemic stroke had higher CHA2DS2-VASc scores but not higher AF burden. After adjusting for age, hypertension, diabetes, anticoagulation, antithrombotic therapy, AF burden, and AF with higher CHA2DS2-VASc score was associated with increased risk for ischemic stroke (hazard ratio (HR), 15.17). CHA2DS2-VASc score > 4.5 was a predictor of significantly higher risk of future stroke (AUC 0.92). Conclusions. In Holter ECG monitoring detected AF, AF burden does not significantly impact the subsequent risk of stroke; whereas, CHA2DS2-VASc scoring is still a robust predictor of stroke risk. This may illustrate that once AF is detected from Holter ECG monitoring, underlying risk factors appear to be more predictive of subsequent stroke risk than atrial fibrillation burden.http://dx.doi.org/10.1155/2022/7619669 |
| spellingShingle | Xiuping Zhuo Meinv Huang How is Ambulatory Electrocardiogram Predictive of Stroke in Atrial Fibrillation Patients? Cardiology Research and Practice |
| title | How is Ambulatory Electrocardiogram Predictive of Stroke in Atrial Fibrillation Patients? |
| title_full | How is Ambulatory Electrocardiogram Predictive of Stroke in Atrial Fibrillation Patients? |
| title_fullStr | How is Ambulatory Electrocardiogram Predictive of Stroke in Atrial Fibrillation Patients? |
| title_full_unstemmed | How is Ambulatory Electrocardiogram Predictive of Stroke in Atrial Fibrillation Patients? |
| title_short | How is Ambulatory Electrocardiogram Predictive of Stroke in Atrial Fibrillation Patients? |
| title_sort | how is ambulatory electrocardiogram predictive of stroke in atrial fibrillation patients |
| url | http://dx.doi.org/10.1155/2022/7619669 |
| work_keys_str_mv | AT xiupingzhuo howisambulatoryelectrocardiogrampredictiveofstrokeinatrialfibrillationpatients AT meinvhuang howisambulatoryelectrocardiogrampredictiveofstrokeinatrialfibrillationpatients |