P-Wave Indices and Risk of Ischemic Stroke: A Systematic Review and Meta-Analysis.
Jinli He,Gary Tse,Panagiotis Korantzopoulos,Konstantinos P. Letsas,Sadeq Ali-Hasan-Al-Saegh,Hooman Kamel,Guangping Li,Gregory Y.H. Lip,Tong Liu +8 more
TLDR
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.Abstract:
Background and Purpose— Atrial cardiomyopathy is associated with an increased risk of ischemic stroke. P-wave terminal force in lead V 1 , 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 V 1 , P-wave duration, and maximum P-wave area were included. P-wave terminal force in lead V 1 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 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 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 V 1 , P-wave duration, and maximum P-wave area are useful electrocardiographic markers that can be used to stratify the risk of incident ischemic stroke.read more
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Journal ArticleDOI
Atrial Cardiopathy and the Risk of Ischemic Stroke in the CHS (Cardiovascular Health Study).
Hooman Kamel,Traci M. Bartz,Mitchell S.V. Elkind,Mitchell S.V. Elkind,Peter M. Okin,Evan L. Thacker,Evan L. Thacker,Kristen K. Patton,Phyllis K. Stein,Christopher DeFilippi,Rebecca F. Gottesman,Susan R. Heckbert,Richard A. Kronmal,Elsayed Z. Soliman,W. T. Longstreth +14 more
TL;DR: In addition to clinically apparent AF, other evidence of abnormal atrial substrate is associated with subsequent ischemic stroke, consistent with the hypothesis that thromboembolism from the left atrium may occur in the setting of several different manifestations of atrial disease.
Journal ArticleDOI
Advanced interatrial block predicts new-onset atrial fibrillation and ischemic stroke in patients with heart failure: The “Bayes' Syndrome-HF” study
Luis Alberto Escobar-Robledo,Antoni Bayés-de-Luna,Josep Lupón,Adrian Baranchuk,Pedro Moliner,Manuel Martínez-Sellés,Elisabet Zamora,Marta de Antonio,Mar Domingo,Germán Cediel,Julio Núñez,Evelyn Santiago-Vacas,Antoni Bayes-Genis +12 more
TL;DR: In patients with HF advanced IAB predicts new-onset AF and ischemic stroke, and future studies must assess whether anticoagulant treatment in Bayes' Syndrome leads to better outcomes in HF.
Journal ArticleDOI
Predictive value of inter-atrial block for new onset or recurrent atrial fibrillation: A systematic review and meta-analysis.
Gary Tse,Cheuk Wai Wong,Mengqi Gong,Wing Tak Wong,George Bazoukis,Sunny H. Wong,Guangping Li,William K.K. Wu,Lap Ah Tse,Konstantinos Lampropoulos,Yunlong Xia,Tong Liu,Adrian Baranchuk +12 more
TL;DR: A systematic review and meta-analysis of the relationship between IAB and AF found that IAB is a significant predictor of both new onset atrial fibrillation and AF recurrence.
Journal ArticleDOI
Refining Prediction of Atrial Fibrillation–Related Stroke Using the P2-CHA2DS2-VASc Score
Ankit Maheshwari,Faye L. Norby,Nicholas S. Roetker,Elsayed Z. Soliman,Ryan J. Koene,Mary R. Rooney,Wesley T. O'Neal,Amil M. Shah,Brian Claggett,Scott D. Solomon,Alvaro Alonso,Rebecca F. Gottesman,Susan R. Heckbert,Lin Y. Chen +13 more
TL;DR: In this article, periods of sinus rhythm present an opportunity to detect prothrombotic atrial remodeling through measurement of P-wave indices (PWIs), which are used to detect atrial fibrillation.
Journal ArticleDOI
Ischemic Stroke Risk in Patients With Nonvalvular Atrial Fibrillation: JACC Review Topic of the Week
TL;DR: The authors review the current and evolving ischemic stroke risk prediction schemes in patients with nonvalvular atrial fibrillation, highlight the strengths and weaknesses of the models, and discuss the unmet needs in this field.
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