| Literature DB >> 26566907 |
Maurizio Paciaroni1, Giancarlo Agnelli2, Nicola Falocci2, Valeria Caso2, Cecilia Becattini2, Simona Marcheselli3, Christina Rueckert4, Alessandro Pezzini5, Loris Poli5, Alessandro Padovani5, Laszló Csiba6, Lilla Szabó6, Sung-Il Sohn7, Tiziana Tassinari8, Azmil H Abdul-Rahim9, Patrik Michel10, Maria Cordier10, Peter Vanacker11, Suzette Remillard10, Andrea Alberti2, Michele Venti2, Monica Acciarresi2, Cataldo D'Amore2, Maria Giulia Mosconi2, Umberto Scoditti12, Licia Denti13, Giovanni Orlandi14, Alberto Chiti14, Gino Gialdini14, Paolo Bovi15, Monica Carletti15, Alberto Rigatelli15, Jukka Putaala16, Turgut Tatlisumak16,17,18, Luca Masotti19, Gianni Lorenzini19, Rossana Tassi20, Francesca Guideri20, Giuseppe Martini20, Georgios Tsivgoulis21,22,23, Kostantinos Vadikolias21, Chrissoula Liantinioti23, Francesco Corea24, Massimo Del Sette25, Walter Ageno26, Maria Luisa De Lodovici27, Giorgio Bono27, Antonio Baldi28, Sebastiano D'Anna28, Simona Sacco29, Antonio Carolei29, Cindy Tiseo29, Davide Imberti30, Dorjan Zabzuni30, Boris Doronin31, Vera Volodina31, Domenico Consoli32, Franco Galati32, Alessio Pieroni33, Danilo Toni33, Serena Monaco34, Mario Maimone Baronello34, Kristian Barlinn35, Lars-Peder Pallesen35, Jessica Kepplinger35, Ulf Bodechtel35, Johannes Gerber35, Dirk Deleu36, Gayane Melikyan36, Faisal Ibrahim36, Naveed Akhtar36, Kennedy R Lees9.
Abstract
Anticoagulant therapy is recommended for the secondary prevention of stroke in patients with atrial fibrillation (AF). T he identification of patients at high risk for early recurrence, which are potential candidates to prompt anticoagulation, is crucial to justify the risk of bleeding associated with early anticoagulant treatment. The aim of this study was to evaluate in patients with acute ischemic stroke and AF the association between findings at trans-thoracic echocardiography (TTE) and 90 days recurrence. In consecutive patients with acute ischemic stroke and AF, TTE was performed within 7 days from hospital admission. Study outcomes were recurrent ischemic cerebrovascular events (stroke or TIA) and systemic embolism. 854 patients (mean age 76.3 ± 9.5 years) underwent a TTE evaluation; 63 patients (7.4%) had at least a study outcome event. Left atrial thrombosis was present in 11 patients (1.3%) among whom 1 had recurrent ischemic event. Left atrial enlargement was present in 548 patients (64.2%) among whom 51 (9.3%) had recurrent ischemic events. The recurrence rate in the 197 patients with severe left atrial enlargement was 11.7%. On multivariate analysis, the presence of atrial enlargement (OR 2.13; 95% CI 1.06-4.29, p = 0.033) and CHA2DS2-VASc score (OR 1.22; 95% CI 1.04-1.45, p = 0.018, for each point increase) were correlated with ischemic recurrences. In patients with AF-associated acute stroke, left atrial enlargement is an independent marker of recurrent stroke and systemic embolism. The risk of recurrence is accounted for by severe atrial enlargement. TTE-detected left atrial thrombosis is relatively uncommon.Entities:
Keywords: Acute stroke; Atrial fibrillation; Echocardiography; Outcome
Mesh：
Year: 2015 PMID： 26566907 DOI： 10.1007/s00415-015-7957-3
Source DB: PubMed Journal: J Neurol ISSN： 0340-5354 Impact factor: 4.849