Jinli He1, Gary Tse2, Panagiotis Korantzopoulos1, Konstantinos P Letsas1, Sadeq Ali-Hasan-Al-Saegh1, Hooman Kamel1, Guangping Li1, Gregory Y H Lip1, Tong Liu1. 1. From the Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, People's Republic of China (J.H., G.L., T.L.); Department of Medicine and Therapeutics (G.T.) and Li Ka Shing Institute of Health Science (G.T.), Chinese University of Hong Kong, SAR, People's Republic of China; First Department of Cardiology, University Hospital of Ioannina, Greece (P.K.); Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, "Evangelismos" General Hospital of Athens, Greece (K.P.L.); Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran (S.A.-H.-A.-S.); Weill Cornell Medical College, New York, NY (H.K.); Institute of Cardiovascular Sciences, University of Birmingham, United Kingdom (G.Y.H.L.); and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Denmark (G.Y.H.L.). 2. From the Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, People's Republic of China (J.H., G.L., T.L.); Department of Medicine and Therapeutics (G.T.) and Li Ka Shing Institute of Health Science (G.T.), Chinese University of Hong Kong, SAR, People's Republic of China; First Department of Cardiology, University Hospital of Ioannina, Greece (P.K.); Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, "Evangelismos" General Hospital of Athens, Greece (K.P.L.); Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran (S.A.-H.-A.-S.); Weill Cornell Medical College, New York, NY (H.K.); Institute of Cardiovascular Sciences, University of Birmingham, United Kingdom (G.Y.H.L.); and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Denmark (G.Y.H.L.). tseg@cuhk.edu.hk liutongdoc@126.com.
Abstract
BACKGROUND AND PURPOSE: Atrial cardiomyopathy is associated with an increased risk of ischemic stroke. P-wave terminal force in lead V1, P-wave duration, and maximum P-wave area are electrocardiographic parameters that have been used to assess left atrial abnormalities related to developing atrial fibrillation. The aim of this systematic review and meta-analysis was to examine their values for predicting ischemic stroke risk. METHODS: PubMed and EMBASE databases were searched until December 2016 for studies that evaluated the association between P-wave indices and stroke risk. Both fixed- and random-effects models were used to calculate the overall effect estimates. RESULTS: Ten studies examining P-wave terminal force in lead V1, P-wave duration, and maximum P-wave area were included. P-wave terminal force in lead V1 was found to be an independent predictor of stroke as both a continuous variable (odds ratio [OR] per 1 SD change, 1.18; 95% confidence interval [CI], 1.12-1.25; P<0.0001) and categorical variable (OR, 1.59; 95% CI, 1.10-2.28; P=0.01). P-wave duration was a significant predictor of incident ischemic stroke when analyzed as a categorical variable (OR, 1.86; 95% CI, 1.37-2.52; P<0.0001) but not when analyzed as a continuous variable (OR, 1.05; 95% CI, 0.98-1.13; P=0.15). Maximum P-wave area also predicted the risk of incident ischemic stroke (OR per 1 SD change, 1.10; 95% CI, 1.04-1.17). CONCLUSIONS: P-wave terminal force in lead V1, P-wave duration, and maximum P-wave area are useful electrocardiographic markers that can be used to stratify the risk of incident ischemic stroke.
BACKGROUND AND PURPOSE:Atrial cardiomyopathy is associated with an increased risk of ischemic stroke. P-wave terminal force in lead V1, P-wave duration, and maximum P-wave area are electrocardiographic parameters that have been used to assess left atrial abnormalities related to developing atrial fibrillation. The aim of this systematic review and meta-analysis was to examine their values for predicting ischemic stroke risk. METHODS: PubMed and EMBASE databases were searched until December 2016 for studies that evaluated the association between P-wave indices and stroke risk. Both fixed- and random-effects models were used to calculate the overall effect estimates. RESULTS: Ten studies examining P-wave terminal force in lead V1, P-wave duration, and maximum P-wave area were included. P-wave terminal force in lead V1 was found to be an independent predictor of stroke as both a continuous variable (odds ratio [OR] per 1 SD change, 1.18; 95% confidence interval [CI], 1.12-1.25; P<0.0001) and categorical variable (OR, 1.59; 95% CI, 1.10-2.28; P=0.01). P-wave duration was a significant predictor of incident ischemic stroke when analyzed as a categorical variable (OR, 1.86; 95% CI, 1.37-2.52; P<0.0001) but not when analyzed as a continuous variable (OR, 1.05; 95% CI, 0.98-1.13; P=0.15). Maximum P-wave area also predicted the risk of incident ischemic stroke (OR per 1 SD change, 1.10; 95% CI, 1.04-1.17). CONCLUSIONS: P-wave terminal force in lead V1, P-wave duration, and maximum P-wave area are useful electrocardiographic markers that can be used to stratify the risk of incident ischemic stroke.
Authors: Hooman Kamel; Traci M Bartz; Mitchell S V Elkind; Peter M Okin; Evan L Thacker; Kristen K Patton; Phyllis K Stein; Christopher R deFilippi; Rebecca F Gottesman; Susan R Heckbert; Richard A Kronmal; Elsayed Z Soliman; W T Longstreth Journal: Stroke Date: 2018-03-13 Impact factor: 7.914
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Authors: Lu-Chen Weng; Amelia Weber Hall; Seung Hoan Choi; Sean J Jurgens; Jeffrey Haessler; Nathan A Bihlmeyer; Niels Grarup; Honghuang Lin; Alexander Teumer; Ruifang Li-Gao; Jie Yao; Xiuqing Guo; Jennifer A Brody; Martina Müller-Nurasyid; Katharina Schramm; Niek Verweij; Marten E van den Berg; Jessica van Setten; Aaron Isaacs; Julia Ramírez; Helen R Warren; Sandosh Padmanabhan; Jan A Kors; Rudolf A de Boer; Peter van der Meer; Moritz F Sinner; Melanie Waldenberger; Bruce M Psaty; Kent D Taylor; Uwe Völker; Jørgen K Kanters; Man Li; Alvaro Alonso; Marco V Perez; Ilonca Vaartjes; Michiel L Bots; Paul L Huang; Susan R Heckbert; Henry J Lin; Jelena Kornej; Patricia B Munroe; Cornelia M van Duijn; Folkert W Asselbergs; Bruno H Stricker; Pim van der Harst; Stefan Kääb; Annette Peters; Nona Sotoodehnia; Jerome I Rotter; Dennis O Mook-Kanamori; Marcus Dörr; Stephan B Felix; Allan Linneberg; Torben Hansen; Dan E Arking; Charles Kooperberg; Emelia J Benjamin; Kathryn L Lunetta; Patrick T Ellinor; Steven A Lubitz Journal: Circ Genom Precis Med Date: 2020-08-21