| 1. |
- Baturova, Maria A., et al.
(författare)
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Non-permanent atrial fibrillation and oral anticoagulant therapy are related to survival during 10years after first-ever ischemic stroke
- 2017
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 232, s. 134-139
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Tidskriftsartikel (refereegranskat)abstract
- Background: Atrial fibrillation (AF) detection in ischemic stroke patients triggers initiation of oral anticoagulant therapy (OAC). However, little is known regarding whether the persistency of AF affects long-term prognosis after ischemic stroke. We aimed to assess the impact of AF types and OAC on the outcome during a 10-year follow-up (FU) after first-ever ischemic stroke. Material and methods: The study sample comprised 336 first-ever ischemic stroke patients (median age 76, interquartile range 25-75% (IQR) 67-82. years, 136 female) included in the Lund Stroke Register (LSR) in 2001-2002. At baseline, 109 patients had either permanent (n = 44) or recurrent (n = 65) AF. OAC was assessed using the Lund University Hospital anticoagulation database. All-cause mortality was assessed via linkage with the Swedish Causes of Death Register. Results: During FU, 200 patients died. AF independently predicted all-cause mortality (hazard ratio (HR) 1.52 95% CI 1.14-2.04, p = 0.005); the worst prognosis was observed for permanent AF (HR 1.86 95% CI 1.29-2.69, p = 0.001). Patients with recurrent AF receiving OAC had similar survival rates to patients without AF (HR 0.73 95% CI 0.38-1.39, p = 0.333), while prognosis was worst for patients with permanent AF without OAC (HR 2.28 95% CI 1.38-3.77, p = 0.001) and intermediate for patients with permanent AF on OAC (HR 1.57 95% CI 0.92-2.67, p = 0.099). Conclusion: All-cause mortality was independently associated with AF and was the greatest in stroke patients with permanent AF. Patients with recurrent AF receiving OAC have the most favorable outcome, similar to those without AF and significantly better than OAC-treated patients with permanent AF.
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| 2. |
- Baturova, Maria, et al.
(författare)
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Atrial fibrillation in patients with ischaemic stroke in the Swedish national patient registers: how much do we miss?
- 2014
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Ingår i: Europace. - : Oxford University Press (OUP). - 1532-2092. ; 16:12, s. 1714-1719
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Tidskriftsartikel (refereegranskat)abstract
- Data from national discharge registers are commonly used to estimate prevalence and incidence of atrial fibrillation (AF) in epidemiology studies. However, sensitivity and specificity of register-based AF diagnosis have not been evaluated. We sought to assess the validity of AF diagnosis in the Swedish Patient Register against electrocardiography (ECG) documentation of AF.
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| 3. |
- Baturova, Maria, et al.
(författare)
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Predictors of new onset atrial fibrillation during 10-year follow-up after first-ever ischemic stroke.
- 2015
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 199, s. 248-252
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Tidskriftsartikel (refereegranskat)abstract
- Paroxysmal atrial fibrillation (AF) may be underdiagnosed in ischemic stroke patients but may be pivotal for initiation of oral anticoagulation therapy. We assessed clinical and ECG predictors of new-onset AF during 10-year follow-up (FU) in ischemic stroke patients.
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| 4. |
- Cortez, Daniel, et al.
(författare)
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Atrial time and voltage dispersion are both needed to predict new-onset atrial fibrillation in ischemic stroke patients
- 2017
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Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Atrial fibrillation (AF) is a known risk factor for ischemic stroke. Electrocardiographic predictors of AF in population studies such as the Framingham Heart Study, as well as in hypertensive patients have demonstrated a predictive value of the P-wave duration for development of AF. QRS vector magnitude has had a predictive value in ventricular arrhythmia development. We aimed to assess the value of the three-dimensional P-wave vector magnitude and its relationship to P-wave duration for prediction of new-onset AF after ischemic stroke. Methods: First-ever ischemic stroke patients without AF at inclusion in the Lund Stroke Register were included. Measurements of P wave duration (Pd), QRS duration, corrected QT interval, and PQ interval were performed automatically using the University of Glasgow 12-lead ECG analysis algorithm. The P-wave vector magnitude (Pvm) was calculated automatically as the square root of the sum of the squared P-wave magnitudes in leads V6, II and one half of the P-wave amplitude in V2 ( PV 6 2 + PII 2 + 0.5 PV 2 2 $$ \sqrt(PV(6)^2+(PII)^2+(\left((0.5)^(\ast )PV2\right))^2) $$ ), based on the P-wave magnitude (Pvm) as defined by the visually transformed Kors' Quasi-orthogonal method. Results: The median age was 73 (IQR 63-80) years at stroke onset (135 males, 92 females). Multivariate predictors of new-onset atrial fibrillation included age>65years, hypertension, and Pd/Pvm. A cut-off value of 870ms/mV gave sensitivity, specificity, positive and negative predictive values of 51, 79, 30 and 87%, respectively. The Pd/Pvm was the only ECG predictor of AF with a significant multivariate hazard ratio of 2.02 (95% CI 1.18 to 3.46, p=0.010). Conclusion: P-wave dispersion as measured by the Pd/Pvm was the only ECG parameter measured which independently predicted subsequent AF identification in a cohort of stroke patients. Further prospective studies in larger cohorts are needed to validate its clinical usefulness.
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