BACKGROUND AND PURPOSE: It is unknown whether supraventricular arrhythmias other than atrial fibrillation or flutter are associated with stroke. METHODS: To examine the association between paroxysmal supraventricular tachycardia (PSVT) and stroke, we performed a retrospective cohort study using administrative claims data from all emergency department encounters and hospitalizations at California's nonfederal acute care hospitals in 2009. Our cohort comprised all adult patients with ≥ 1 emergency department visit or hospitalization from which they were discharged alive and without a diagnosis of stroke. Our primary exposure was a diagnosis of PSVT recorded at an encounter before stroke or documented as present-on-admission at the time of stroke. To reduce confounding, we excluded patients with diagnoses of atrial fibrillation. We defined PSVT, stroke, and atrial fibrillation using International Classification of Diseases, Ninth Revision, Clinical Modification codes previously validated by detailed chart review. RESULTS: Of 4 806 830 eligible patients, 14 121 (0.29%) were diagnosed with PSVT and 14 402 (0.30%) experienced a stroke. The cumulative rate of stroke after PSVT diagnosis (0.94%; 95% confidence interval, 0.76%-1.16%) significantly exceeded the rate among patients without a diagnosis of PSVT (0.21%; 95% confidence interval, 0.21%-0.22%). In Cox proportional hazards analysis controlling for demographic characteristics and potential confounders, PSVT was independently associated with a higher risk of subsequent stroke (hazard ratio, 2.10; 95% confidence interval, 1.69-2.62). CONCLUSIONS: In a large and demographically diverse sample of patients, we found an independent association between PSVT and ischemic stroke. PSVT seems to be a novel risk factor that may account for some proportion of strokes that are currently classified as cryptogenic.
BACKGROUND AND PURPOSE: It is unknown whether supraventricular arrhythmias other than atrial fibrillation or flutter are associated with stroke. METHODS: To examine the association between paroxysmal supraventricular tachycardia (PSVT) and stroke, we performed a retrospective cohort study using administrative claims data from all emergency department encounters and hospitalizations at California's nonfederal acute care hospitals in 2009. Our cohort comprised all adult patients with ≥ 1 emergency department visit or hospitalization from which they were discharged alive and without a diagnosis of stroke. Our primary exposure was a diagnosis of PSVT recorded at an encounter before stroke or documented as present-on-admission at the time of stroke. To reduce confounding, we excluded patients with diagnoses of atrial fibrillation. We defined PSVT, stroke, and atrial fibrillation using International Classification of Diseases, Ninth Revision, Clinical Modification codes previously validated by detailed chart review. RESULTS: Of 4 806 830 eligible patients, 14 121 (0.29%) were diagnosed with PSVT and 14 402 (0.30%) experienced a stroke. The cumulative rate of stroke after PSVT diagnosis (0.94%; 95% confidence interval, 0.76%-1.16%) significantly exceeded the rate among patients without a diagnosis of PSVT (0.21%; 95% confidence interval, 0.21%-0.22%). In Cox proportional hazards analysis controlling for demographic characteristics and potential confounders, PSVT was independently associated with a higher risk of subsequent stroke (hazard ratio, 2.10; 95% confidence interval, 1.69-2.62). CONCLUSIONS: In a large and demographically diverse sample of patients, we found an independent association between PSVT and ischemic stroke. PSVT seems to be a novel risk factor that may account for some proportion of strokes that are currently classified as cryptogenic.
Authors: Dwayne S G Conway; Lesly A Pearce; Bernard S P Chin; Robert G Hart; Gregory Y H Lip Journal: Circulation Date: 2002-10-08 Impact factor: 29.690
Authors: Hooman Kamel; Babak B Navi; Lucas Elijovich; S Andrew Josephson; Alan H Yee; Gordon Fung; S Claiborne Johnston; Wade S Smith Journal: Stroke Date: 2012-11-27 Impact factor: 7.914
Authors: Shadi Yaghi; Yeseon P Moon; Consuelo Mora-McLaughlin; Joshua Z Willey; Ken Cheung; Marco R Di Tullio; Shunichi Homma; Hooman Kamel; Ralph L Sacco; Mitchell S V Elkind Journal: Stroke Date: 2015-04-23 Impact factor: 7.914
Authors: Emelia J Benjamin; Michael J Blaha; Stephanie E Chiuve; Mary Cushman; Sandeep R Das; Rajat Deo; Sarah D de Ferranti; James Floyd; Myriam Fornage; Cathleen Gillespie; Carmen R Isasi; Monik C Jiménez; Lori Chaffin Jordan; Suzanne E Judd; Daniel Lackland; Judith H Lichtman; Lynda Lisabeth; Simin Liu; Chris T Longenecker; Rachel H Mackey; Kunihiro Matsushita; Dariush Mozaffarian; Michael E Mussolino; Khurram Nasir; Robert W Neumar; Latha Palaniappan; Dilip K Pandey; Ravi R Thiagarajan; Mathew J Reeves; Matthew Ritchey; Carlos J Rodriguez; Gregory A Roth; Wayne D Rosamond; Comilla Sasson; Amytis Towfighi; Connie W Tsao; Melanie B Turner; Salim S Virani; Jenifer H Voeks; Joshua Z Willey; John T Wilkins; Jason Hy Wu; Heather M Alger; Sally S Wong; Paul Muntner Journal: Circulation Date: 2017-01-25 Impact factor: 29.690
Authors: Shadi Yaghi; Amelia K Boehme; Rebecca Hazan; Eldad A Hod; Alberto Canaan; Howard F Andrews; Hooman Kamel; Randolph S Marshall; Mitchell S V Elkind Journal: J Stroke Cerebrovasc Dis Date: 2015-10-21 Impact factor: 2.136
Authors: Wesley T O'Neal; Hooman Kamel; Dawn Kleindorfer; Suzanne E Judd; George Howard; Virginia J Howard; Elsayed Z Soliman Journal: Neuroepidemiology Date: 2016-08-17 Impact factor: 3.282
Authors: Hooman Kamel; Elsayed Z Soliman; Susan R Heckbert; Richard A Kronmal; W T Longstreth; Saman Nazarian; Peter M Okin Journal: Stroke Date: 2014-07-22 Impact factor: 7.914