PMID: 9634425Jun 20, 1998Paper

Predictors of systemic embolism in patients with mitral stenosis. A prospective study

Annals of Internal Medicine
C W ChiangC H Chang

Abstract

Most studies of the predictors of systemic embolism in patients with mitral stenosis have been retrospective. To prospectively study factors associated with systemic embolism in mitral stenosis. Prospective cohort study. University-affiliated medical institution with 3000 beds. 534 consecutive patients with a mitral valve area of 2.0 cm2 or less; 132 patients were in sinus rhythm, and 402 were in atrial fibrillation. Nine clinical and 10 echocardiographic variables were assessed for prediction of systemic embolism over a mean (+/- SD) follow-up of 36.9 +/- 22.5 months. Diagnosis of systemic embolism was based on symptoms and signs (sudden onset of peripheral arterial ischemic or neurologic manifestations without prodromes) and on findings on computed tomography, angiography, and surgery. For patients in sinus rhythm, age (relative risk [RR], 1.12 [95% CI, 1.04 to 1.21]), the presence of a left atrial thrombus (RR, 37.1 [CI, 2.82 to 487.8]), mitral valve area (RR, 16.9 [CI, 1.53 to 187.0]), and the presence of significant aortic regurgitation (RR, 22.4 [CI, 2.72 to 184.8]) were positively associated with embolism. For patients in atrial fibrillation, previous embolism (RR, 3.11 [CI, 1.66 to 5.85]) was positively associated with ...Continue Reading

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