Left Atrial Size and Ischemic Events after Ischemic Stroke or Transient Ischemic Attack in Patients with Nonvalvular Atrial Fibrillation

被引：10

作者：

Tokunaga, Keisuke ^{[1
]}

Koga, Masatoshi ^{[1
]}

Yoshimura, Sohei ^{[1
]}

Okada, Yasushi ^{[2
]}

Yamagami, Hiroshi ^{[3
]}

Todo, Kenichi ^{[4
]}

Itabashi, Ryo ^{[5
]}

Kimura, Kazumi ^{[6
]}

Sato, Shoichiro ^{[1
]}

Terasaki, Tadashi ^{[7
]}

Inoue, Manabu ^{[1
]}

Shiokawa, Yoshiaki ^{[8
,9
]}

Takagi, Masahito ^{[1
]}

Kamiyama, Kenji ^{[10
]}

Tanaka, Kanta ^{[3
]}

Takizawa, Shunya ^{[11
]}

Shiozawa, Masayuki ^{[1
]}

Okuda, Satoshi ^{[12
]}

Kameda, Tomoaki ^{[13
]}

Nagakane, Yoshinari ^{[14
]}

Hasegawa, Yasuhiro ^{[15
]}

Shibuya, Satoshi ^{[16
]}

Ito, Yasuhiro ^{[17
]}

Matsuoka, Hideki ^{[18
]}

Takamatsu, Kazuhiro ^{[19
]}

Nishiyama, Kazutoshi ^{[20
]}

Kario, Kazuomi ^{[21
]}

Yagita, Yoshiki ^{[22
]}

Mizoguchi, Tadataka ^{[1
]}

Fujita, Kyohei ^{[1
]}

Ando, Daisuke ^{[1
]}

Kumamoto, Masaya ^{[1
]}

Miwa, Kaori ^{[1
]}

Arihiro, Shoji ^{[3
]}

Toyoda, Kazunori ^{[1
]}

机构：

[1] Natl Cerebral & Cardiovasc Ctr, Dept Cerebrovasc Med, 5-7-1 Fujishirodai, Suita, Osaka 5658565, Japan

[2] NHO Kyushu Med Ctr, Dept Neurol & Cerebrovasc Med, Fukuoka, Japan

[3] Natl Cerebral & Cardiovasc Ctr, Div Stroke Care Unit, Suita, Osaka, Japan

[4] Osaka Univ, Dept Neurol, Grad Sch Med, Suita, Osaka, Japan

[5] Kohnan Hosp, Dept Stroke Neurol, Sendai, Miyagi, Japan

[6] Nippon Med Sch, Grad Sch Med, Dept Neurol Sci, Tokyo, Japan

[7] Japanese Red Cross Kumamoto Hosp, Dept Neurol, Kumamoto, Japan

[8] Kyorin Univ, Dept Neurosurg, Sch Med, Mitaka, Tokyo, Japan

[9] Kyorin Univ, Stroke Ctr, Sch Med, Mitaka, Tokyo, Japan

[10] Nakamura Mem Hosp, Dept Neurosurg, Sapporo, Hokkaido, Japan

[11] Tokai Univ, Dept Neurol, Sch Med, Isehara, Kanagawa, Japan

[12] NHO Nagoya Med Ctr, Dept Neurol, Nagoya, Aichi, Japan

[13] Jichi Med Univ, Div Neurol, Sch Med, Shimotsuke, Tochigi, Japan

[14] Kyoto Second Red Cross Hosp, Dept Neurol, Kyoto, Japan

[15] St Marianna Univ, Dept Neurol, Sch Med, Kawasaki, Kanagawa, Japan

[16] South Miyagi Med Ctr, Dept Neurol, Ogawara, Japan

[17] TOYOTA Mem Hosp, Dept Neurol, Toyota, Japan

[18] NHO Kagoshima Med Ctr, Dept Cerebrovasc Med, Kagoshima, Japan

[19] Brain Attack Ctr Ota Mem Hosp, Dept Neurol, Fukuyama, Hiroshima, Japan

[20] Kitasato Univ, Dept Neurol, Sch Med, Sagamihara, Kanagawa, Japan

[21] Jichi Med Univ, Div Cardiovasc Med, Sch Med, Shimotsuke, Tochigi, Japan

[22] Kawasaki Med Sch, Dept Stroke Med, Kurashiki, Okayama, Japan

来源：

CEREBROVASCULAR DISEASES | 2020年 / 49卷 / 06期

关键词：

Atrial fibrillation; Ischemic stroke; Left atrial size; Transient ischemic attack; CRYPTOGENIC STROKE; RISK-FACTORS; CARDIOPATHY; RECOMMENDATIONS; PREVENTION; PERSISTENT; DEATH;

D O I：

10.1159/000511393

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: The present study aimed to clarify the association between left atrial (LA) size and ischemic events after ischemic stroke or transient ischemic attack (TIA) in patients with nonvalvular atrial fibrillation (NVAF). Methods: Acute ischemic stroke or TIA patients with NVAF were enrolled. LA size was classified into normal LA size, mild LA enlargement (LAE), moderate LAE, and severe LAE. The ischemic event was defined as ischemic stroke, TIA, carotid endarterectomy, carotid artery stenting, acute coronary syndrome or percutaneous coronary intervention, systemic embolism, aortic aneurysm rupture or dissection, peripheral artery disease requiring hospitalization, or venous thromboembolism. Results: A total of 1,043 patients (mean age, 78 years; 450 women) including 1,002 ischemic stroke and 41 TIA were analyzed. Of these, 351 patients (34%) had normal LA size, 298 (29%) had mild LAE, 198 (19%) had moderate LAE, and the remaining 196 (19%) had severe LAE. The median follow-up duration was 2.0 years (interquartile range, 0.9-2.1). During follow-up, 117 patients (11%) developed at least one ischemic event. The incidence rate of total ischemic events increased with increasing LA size. Severe LAE was independently associated with increased risk of ischemic events compared with normal LA size (multivariable-adjusted hazard ratio, 1.75; 95% confidence interval, 1.02-3.00). Conclusion: Severe LAE was associated with increased risk of ischemic events after ischemic stroke or TIA in patients with NVAF.

引用

页码：619 / 624

页数：6

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