Association between excessive premature atrial complexes and cryptogenic stroke: results of a case-control study

BMJ Open
Jithin K SajeevAndrew W Teh

Abstract

Recent anticoagulation trials in all-comer cryptogenic stroke patients have yielded equivocal results, reinvigorating the focus on identifying reproducible markers of an atrial myopathy. We investigated the role of excessive premature atrial complexes (PACs) in ischaemic stroke, including cryptogenic stroke and its association with vascular risk factors. A case-control study was conducted utilising a multicentre institutional stroke database to compare 461 patients with an ischaemic stroke or transient ischaemic attack (TIA) with a control group consisting of age matched patients without prior history of ischaemic stroke/TIA. All patients underwent 24-hour Holter monitoring during the study period and atrial fibrillation was excluded. An excessive PAC burden, defined as ≥200 PACs/24 hours, was present in 25.6% and 14.7% (p<0.01), of stroke/TIA and control patients, respectively. On multivariate regression, excessive PACs (OR 1.97; 95% CI 1.29 to 3.02; p<0.01), smoking (OR 1.58; 95% CI 1.06 to 2.36; p<0.05) and hypertension (OR 1.53; 95% CI 1.07 to 2.17; p<0.05) were independently associated with ischaemic stroke/TIA. Excessive PACs remained the strongest independent risk factor for the cryptogenic stroke subtype (OR 1.95; 95% C...Continue Reading

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Citations

Dec 23, 2020·Stroke; a Journal of Cerebral Circulation·Anoop N KoshyAndrew W Teh
Mar 21, 2020·JACC. Clinical Electrophysiology·Jithin K SajeevAndrew W Teh
May 8, 2021·Mayo Clinic Proceedings·Chaitra Janga, Malini Madhavan

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Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

MARS Ambulatory ECG Analysis System
SPSS Statistics

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