Arrhythmias & electrophysiology
Left Atrial Mechanical Dysfunction and the Risk for Ischemic Stroke in People Without Prevalent Atrial Fibrillation or Stroke : A Prospective Cohort Study
Authors' conclusion
In people without prior AF or stroke, when added to CHA2DS2-VASc variables, left atrial reservoir strain improves stroke prediction and yields a predicted net benefit, as shown by decision curve analysis.
Study context
- Population
- ARIC participants without prevalent stroke or atrial fibrillation (AF)
- Participants
- 4,917 participants
- Exposure
- LA function (reservoir, conduit, contractile strain) and LA size (LA volume index) added to CHA2DS2-VASc variables for ischemic stroke prediction
- Outcome
- Ischemic stroke (physician-adjudicated, 2011 to 2019)
- Follow-up
- 5 years
Methodological detailsLimitation: underascertainment of subclinical AF
- Limitation: underascertainment of subclinical AF
Main finding
As reported in the abstract
Cumulative incidence of ischemic stroke
Observational data: associations, not effects.
Further findings
Reclassification with LA reservoir strain added to CHA2DS2-VASc variables · 5 years
- Participants with stroke (n=112) reclassified to higher risk
- 11.6%
- Participants with stroke (n=112) reclassified to lower risk
- 1.8%
- Participants without stroke (n=4805) reclassified to lower risk
- 12.2%
- Participants without stroke (n=4805) reclassified to higher risk
- 12.7%
Decision curve analysis · 5-year risk threshold of 5%
- Predicted net benefit
- 1.34 per 1000 people
Original publication
Left Atrial Mechanical Dysfunction and the Risk for Ischemic Stroke in People Without Prevalent Atrial Fibrillation or Stroke : A Prospective Cohort Study. Ann Intern Med. Published 20 December 2022. doi:10.
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