Evaluation of electrocardiographic P wave parameters in predicting long-term atrial fibrillation in patients with acute ischemic stroke

Çınar, Tufan; Hayıroğlu, Mert İlker; Selçuk, Murat; Çinier, Göksel; Çiçek, Vedat; Doğan, Selami; Kılıç, Şahhan; Asal, Süha; Atmaca, Murat Mert; Orhan, Ahmet Lütfüllah

doi:10.1055/s-0042-1755322

Cited by 6 publications

(7 citation statements)

References 21 publications

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“…Actually, ECG examination plays a vital role in AF detection. 57 Interatrial block and P wave parameters are other confirmed risk factors for AF, 58 which was different from our study. Previous research has focused on patients with an acute ischemic stroke rather than postoperative patients, who might have a different trigger of AF and experience fewer cardiovascular events before surgery.…”

Section: Discussioncontrasting

confidence: 99%

Association of Mitral Regurgitation with Postoperative Atrial Fibrillation in Critically Ill Noncardiac Surgery Patients: A Prospective Cohort Study

Zhang¹,

Wang²,

Jiang³

et al. 2023

IJGM

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Purpose Atrial fibrillation (AF) is common in critically ill patients and can have serious consequences. Postoperative AF (POAF) in critically ill patients following noncardiac surgery has been understudied, contrary to cardiac procedures. Mitral regurgitation (MR) is associated with left ventricular dysfunction, which might contribute to the occurrence of AF in postoperative critically ill patients. This study aimed to investigate the association between MR and POAF in critically ill noncardiac surgery patients and establish a new nomogram for the prediction of POAF in critically ill noncardiac surgery patients. Patients and Methods A prospective cohort of 2474 patients who underwent thoracic and general surgery was enrolled in this study. Data on preoperative transthoracic echocardiography (TTE), electrocardiogram (ECG), and several commonly utilized scoring systems (CHA2DS2‐VASc, HATCH, COM-AF, HART, and C2HEST) and baseline clinical data were collected. Independent predictors were selected by univariate and multivariable logistic regression analysis, and a nomogram was constructed for POAF within 7 days after postoperative intensive care unit (ICU) admission. The ability of the MR-nomogram and other scoring systems to predict POAF was compared by receiver operator characteristic (ROC) curve analysis and decision curve analysis (DCA). Additional contributions were evaluated by integrated discrimination improvement (IDI) and net reclassification improvement (NRI) analysis. Results A total of 213 (8.6%) patients developed POAF within 7 days after ICU admission. Compared to CHA2DS2‐VASc, HATCH, COM-AF, HART, and C2HEST scoring systems, MR-nomogram showed better predictive ability for POAF with an area under the ROC curve of 0.824 (95% confidence interval: 0.805–0.842, p < 0.001). The improvement of the MR-nomogram in predictive value was supported by NRI and IDI analysis. The net benefit of the MR nomogram was maximal in DCA. Conclusion MR is an independent risk factor of POAF in critically ill noncardiac surgery patients. The nomogram predicted POAF better than other scoring systems.

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Section: Discussioncontrasting

confidence: 99%

Association of Mitral Regurgitation with Postoperative Atrial Fibrillation in Critically Ill Noncardiac Surgery Patients: A Prospective Cohort Study

Zhang¹,

Wang²,

Jiang³

et al. 2023

IJGM

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“…In addition, there has been a significant increase in diagnostics for previously undetected AF after stroke, such as long-term ECG monitoring with mobile ambulatory cardiac telemetry or implantable devices. There are also reports that have shown that a new ECG parameter, P-wave peak time, may be useful in predicting the risk of developing paroxysmal AF among patients with acute ischemic stroke [ 29 , 30 ]. Early implementation of effective cardiovascular incident prevention strategies may improve long-term survival after stroke.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes after Stroke in Patients with Atrial Fibrillation: A Single Center Study

Tracz

Gorczyca

Rosołowska

et al. 2023

IJERPH

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Atrial fibrillation (AF) is known to be a significant risk factor for poor prognosis after stroke. In this study, we compared differences in long-term outcomes after ischemic stroke among patients with AF and sinus rhythm (SR). We identified patients admitted to the reference Neurology Center between 1 January 2013 and 30 April 2015, inclusive, with acute ischemic stroke. Of the 1959 surviving patients, 892 were enrolled and followed for five years or until death. We analyzed the risk of stroke recurrence and death between patients with AF and SR at 1, 3, and 5 years after stroke. The rates of death and stroke recurrence were estimated using Kaplan–Meier analysis and multivariate Cox regression. During follow-up, 17.8% of patients died and 14.6% had recurrent stroke. The mortality in the AF group increased relative to the SR group with subsequent years. The risk of death was statistically higher in the AF than SR group at 1 year after stroke (13.5 vs. 7%, p = 0.004). After adjusting for age, stroke severity, and comorbidities, there was also no significant effect of AF on mortality in the first year after stroke (OR = 1.59, p = 0.247). There were no significant differences between the groups in stroke recurrence during follow-up. The results of our study showed that post-stroke patients with AF have a more severe prognosis, although AF itself does not have an independent negative effect on long-term outcomes after stroke. Long-term survival after stroke in patients with AF was strongly associated with age, stroke severity, and heart failure. The impact of other factors on prognosis after stroke in patients with AF should be considered.

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“…Ischemic stroke leads to a high prevalence of disability and mortality worldwide, especially in patients with cardioembolic stroke and atherothrombotic stroke. [1][2][3][4] It has been confirmed that mechanical thrombectomy (MT) is a beneficial treatment for ischemic stroke patients who have suffered large artery occlusion. 5 However, symptomatic intracranial hemorrhage (sICH) is a serious complication that can occur in ischemic stroke patients after MT treatment, leading to an increased risk of morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Liver Fibrosis and Increased Risk of Symptomatic Intracranial Hemorrhage in Ischemic Stroke Patients Undergoing Mechanical Thrombectomy

Xu,

Zhang,

et al. 2024

NDT

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Background Liver fibrosis has been reported to be associated with hematoma expansion and mortality in patients with intracerebral hemorrhage. This study aimed to detect the association between liver fibrosis and symptomatic intracranial hemorrhage (sICH) in ischemic stroke after mechanical thrombectomy (MT). Methods We retrospectively included patients with large artery occlusion in the anterior circulation and treated with MT at a single stroke center. The fibrosis-4 index (FIB-4) was used to assess the severity of liver fibrosis. sICH was diagnosed according to the Heidelberg Bleeding Classification criteria. Multivariate logistic regression and restricted cubic spline analysis were conducted to examine the relationship between liver fibrosis and sICH. Results Among the 578 patients (mean age, 70.1 years; 58.5% male) included in the study, 65 (11.2%) individuals were diagnosed with sICH. After adjusting for demographic characteristics and other potential confounders, a higher FIB-4 index was found to be independently associated with an increased risk of sICH (odds ratio: 1.306, 95% confidence interval: 1.127–1.512, P =0.001). Similar results were obtained when analyzing FIB-4 as a categorical variable. Conclusion This study demonstrated that there is a significant association between FIB-4 and the risk of sICH in patients with acute ischemic stroke who underwent MT. Therefore, liver fibrosis could serve as a valuable parameter in monitoring the risk of sICH following MT.

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Evaluation of electrocardiographic P wave parameters in predicting long-term atrial fibrillation in patients with acute ischemic stroke

Cited by 6 publications

References 21 publications

Association of Mitral Regurgitation with Postoperative Atrial Fibrillation in Critically Ill Noncardiac Surgery Patients: A Prospective Cohort Study

Association of Mitral Regurgitation with Postoperative Atrial Fibrillation in Critically Ill Noncardiac Surgery Patients: A Prospective Cohort Study

Long-Term Outcomes after Stroke in Patients with Atrial Fibrillation: A Single Center Study

Relationship Between Liver Fibrosis and Increased Risk of Symptomatic Intracranial Hemorrhage in Ischemic Stroke Patients Undergoing Mechanical Thrombectomy

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