Left atrial function to identify patients with atrial fibrillation at high risk of stroke: new insights from a large registry
Authors' conclusion
The assessment of LA reservoir strain and PA-TDI on echocardiography after initial CHA2DS2-VASc scoring provides additional risk stratification for stroke and may be useful to guide decisions regarding anticoagulation for patients upon first diagnosis of AF.
Study context
- Population
- Patients with first diagnosis of atrial fibrillation (AF) and baseline transthoracic echocardiogrammean age 65±12 years, 74% males
- Participants
- 1,361 patients
- Exposure
- Stroke vs Non-stroke
- Stroken = 100
- Outcome
- Ischaemic stroke
- Follow-up
- Mean 7.9 years
Methodological detailsregistry, Follow-up by chart review; Cox proportional hazard models
- Registry
- Follow-up by chart review; Cox proportional hazard models
Main finding
As reported in the abstract
LA function parameters, stroke vs non-stroke
LA reservoir strain
P = 0.005
LA conduit strain
P = 0.013
ms
| Outcome | Stroke | Non-stroke | P value |
|---|---|---|---|
| PA-TDI | 166 | 141 | P < 0.001 |
Observational data: associations, not effects.
Further findings
Ischaemic stroke incidence
- Ischaemic stroke
- 100 (7%)
- Annualized stroke rate
- 0.9%
- Stroke rate in year after first AF diagnosis (higher than remainder of follow-up)
- 2.6%
Original publication
Left atrial function to identify patients with atrial fibrillation at high risk of stroke: new insights from a large registry. Eur Heart J. Published 28 December 2017. doi:10.
Summarised from the published abstract; every number is checked against it