Sebastian Fridman1, Amado Jimenez-Ruiz2, Juan Camilo Vargas-Gonzalez2,3, Luciano A Sposato1,2,3,4,5,6. 1. Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. 2. Heart & Brain Laboratory, Western University, London, Canada, Western University, London, Ontario, Canada. 3. Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, London, Ontario, Canada. 4. Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, London, Ontario, Canada. 5. Robarts Research Institute, London, Ontario, Canada. 6. Lawson Health Research Institute, London, Ontario, Canada.
Abstract
BACKGROUND: Preliminary evidence suggests that patients with atrial fibrillation (AF) detected after stroke (AFDAS) may have a lower prevalence of cardiovascular comorbidities and lower risk of stroke recurrence than AF known before stroke (KAF). OBJECTIVE: We performed a systematic search and meta-analysis to compare the characteristics of AFDAS and KAF. METHODS: We searched PubMed, Scopus, and EMBASE for articles reporting differences between AFDAS and KAF until June 30, 2021. We performed random- or fixed-effects meta-analyses to evaluate differences between AFDAS and KAF in demographic factors, vascular risk factors, prevalent vascular comorbidities, structural heart disease, stroke severity, insular cortex involvement, stroke recurrence, and death. RESULTS: In 21 studies including 22,566 patients with ischemic stroke or transient ischemic attack, the prevalence of coronary artery disease, congestive heart failure, prior myocardial infarction, and a history of cerebrovascular events was significantly lower in AFDAS than KAF. Left atrial size was smaller, and left ventricular ejection fraction was higher in AFDAS than KAF. The risk of recurrent stroke was 26% lower in AFDAS than in KAF. There were no differences in age, sex, stroke severity, or death rates between AFDAS and KAF. There were not enough studies to report differences in insular cortex involvement between AF types. CONCLUSIONS: We found significant differences in the prevalence of vascular comorbidities, structural heart disease, and stroke recurrence rates between AFDAS and KAF, suggesting that they constitute different clinical entities within the AF spectrum. PROSPERO registration number is CRD42020202622.
BACKGROUND: Preliminary evidence suggests that patients with atrial fibrillation (AF) detected after stroke (AFDAS) may have a lower prevalence of cardiovascular comorbidities and lower risk of stroke recurrence than AF known before stroke (KAF). OBJECTIVE: We performed a systematic search and meta-analysis to compare the characteristics of AFDAS and KAF. METHODS: We searched PubMed, Scopus, and EMBASE for articles reporting differences between AFDAS and KAF until June 30, 2021. We performed random- or fixed-effects meta-analyses to evaluate differences between AFDAS and KAF in demographic factors, vascular risk factors, prevalent vascular comorbidities, structural heart disease, stroke severity, insular cortex involvement, stroke recurrence, and death. RESULTS: In 21 studies including 22,566 patients with ischemic stroke or transient ischemic attack, the prevalence of coronary artery disease, congestive heart failure, prior myocardial infarction, and a history of cerebrovascular events was significantly lower in AFDAS than KAF. Left atrial size was smaller, and left ventricular ejection fraction was higher in AFDAS than KAF. The risk of recurrent stroke was 26% lower in AFDAS than in KAF. There were no differences in age, sex, stroke severity, or death rates between AFDAS and KAF. There were not enough studies to report differences in insular cortex involvement between AF types. CONCLUSIONS: We found significant differences in the prevalence of vascular comorbidities, structural heart disease, and stroke recurrence rates between AFDAS and KAF, suggesting that they constitute different clinical entities within the AF spectrum. PROSPERO registration number is CRD42020202622.
Authors: Alexandros A Polymeris; Annaelle Zietz; Fabian Schaub; Louisa Meya; Christopher Traenka; Sebastian Thilemann; Benjamin Wagner; Lisa Hert; Valerian L Altersberger; David J Seiffge; Flurina Lyrer; Tolga Dittrich; Ines Piot; Josefin Kaufmann; Lea Barone; Ludvig Dahlheim; Sophie Flammer; Nikolaos S Avramiotis; Nils Peters; Gian Marco De Marchis; Leo H Bonati; Henrik Gensicke; Stefan T Engelter; Philippe A Lyrer Journal: Eur Stroke J Date: 2022-05-10
Authors: Cheng-Yang Hsieh; Hsuan-Min Kao; Kuan-Lin Sung; Luciano A Sposato; Sheng-Feng Sung; Swu-Jane Lin Journal: Front Cardiovasc Med Date: 2022-04-29
Authors: Jan F Scheitz; Luciano A Sposato; Jeanette Schulz-Menger; Christian H Nolte; Johannes Backs; Matthias Endres Journal: J Am Heart Assoc Date: 2022-09-03 Impact factor: 6.106