Excessive supraventricular ectopic activity was significantly associated with an increased risk of new-onset ischemic stroke (HR 2.798; 95% CI 1.064-7.359; P=0.037).
Cohort (n=446)
Yes
Does excessive supraventricular ectopic activity predict new-onset ischemic stroke and all-cause mortality in patients without a history of atrial fibrillation or stroke?
446 patients without a history of atrial fibrillation or stroke across three hospitals in China
Excessive supraventricular ectopic activity (ESVEA) defined as the top 15% of the cohort based on 24-hour ambulatory ECG monitoring
Non-ESVEA group (below the top 15th percentile)
New-onset ischemic stroke and all-cause mortalityhard clinical
Excessive supraventricular ectopic activity is an independent predictor of new-onset ischemic stroke and all-cause mortality in patients without prior atrial fibrillation or stroke.
Effect estimate: HR 2.798 (95% CI 1.064-7.359)
p-value: p=0.037
Abstract Background and aims Excessive supraventricular ectopic activity (ESVEA), a marker of paroxysmal atrial fibrillation (pAF) and atrial cardiomyopathy, may predict cryptogenic ischemic stroke earlier than pAF. This study aimed to explore the link between ESVEA and the risks of new-onset ischemic stroke and all-cause mortality in an Asian population and identify its predictive threshold. Methods This study collected data from 446 patients without a history of atrial fibrillation or stroke across three hospitals in China. Based on 24-hour ambulatory ECG monitoring, patients in the top 15% of the cohort were classified as the ESVEA group, while the rest were the non-ESVEA group. A Cox regression, with age modeled as a time-dependent covariate, was used to compare the incidence of new-onset ischemic stroke and all-cause mortality between the two groups during follow-up. Results The median follow-up duration was 13 months. After adjusting for confounding factors, ESVEA was significantly associated with new-onset ischemic stroke (HR: 2.798; 95% CI: 1.064–7.359; P = 0.037) and all-cause mortality (HR: 7.584; 95% CI: 1.302–44.163; P = 0.024). Subgroup analysis showed a consistent effect of ESVEA on new-onset ischemic stroke across different age groups. The rates of new-onset stroke in the non-ESVEA group (below the top 15th percentile but with supraventricular arrhythmia ESVEA+/- and non-supraventricular arrhythmia ESVEA-) and the ESVEA+ group were 0.70%, 5.90%, and 16.30%, respectively, showing a stepwise increase. Conclusions ESVEA in apparently healthy subjects is independently associated with the risks of new-onset ischemic stroke and all-cause mortality. Conflict of interest "Yujie Tang. nothing to disclose"."Yapeng Lin. nothing to disclose"."Guoliang Zhu. nothing to disclose"."Ruijuan Gang. nothing to disclose"."Qi Wang. nothing to disclose"."Rong Wang. nothing to disclose"."Yuetong Luo. nothing to disclose"."Jie Yang. nothing to disclose".
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Yujie Tang
Chengdu Medical College
Yapeng Lin
Chengdu Medical College
Guoliang Zhu
University of Electronic Science and Technology of China
European Stroke Journal
University of Electronic Science and Technology of China
Chengdu Medical College
First Affiliated Hospital of Chengdu Medical College
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Tang et al. (Fri,) conducted a cohort in Patients without a history of atrial fibrillation or stroke (n=446). Excessive supraventricular ectopic activity (ESVEA) vs. Non-ESVEA was evaluated on New-onset ischemic stroke (HR 2.798, 95% CI 1.064-7.359, p=0.037). Excessive supraventricular ectopic activity was significantly associated with an increased risk of new-onset ischemic stroke (HR 2.798; 95% CI 1.064-7.359; P=0.037).
synapsesocial.com/papers/69fd7fcdbfa21ec5bbf08682 — DOI: https://doi.org/10.1093/esj/aakag023.413