Coronary CTA to Investigate Predictive Value of Left Atrial Appendage for Cardiogenic Stroke in Patients with Nonvalvular Atrial Fibrillation

Q: What is the clinical evidence from this study?

Study design: Case-Control. Population: Nonvalvular Atrial Fibrillation (n=179). Intervention: Coronary CTA (LAAOA Index and LAAEF). Primary outcome: Cardiogenic stroke (AUC 0.786).

Run-Rong Wang; Chunhong Hu; Zheng Li; Shuai Zhang; Wei Li; Hongling Hou

doi:10.1155/2020/7351876

January 1, 2020BioMed Research InternationalOpen Access

Coronary CTA to Investigate Predictive Value of Left Atrial Appendage for Cardiogenic Stroke in Patients with Nonvalvular Atrial Fibrillation

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Key result

Combined LAAOA Index and LAAEF outperforms either alone for predicting cardiogenic stroke in NVAF.

AUC 0.786
n=179

Figures

Why the study?

Do coronary CTA-derived left atrial appendage parameters (LAAOA Index and LAAEF) predict cardiogenic stroke in patients with nonvalvular atrial fibrillation?

Study Design

Type

Case-Control (n=179)

Structured PICO

Do coronary CTA-derived left atrial appendage parameters (LAAOA Index and LAAEF) predict cardiogenic stroke in patients with nonvalvular atrial fibrillation?

P

Population

179 patients with nonvalvular atrial fibrillation (NVAF) who underwent coronary CTA examination (87 cases with cardiogenic stroke, 92 controls without stroke or TIA).

I

Intervention

Coronary CTA-derived Left Atrial Appendage (LAA) parameters (LAAOA Index, LAAEF).

C

Comparator

Patients without stroke or TIA (controls).

O

Outcome

Predictive ability for cardiogenic stroke within 2 years after coronary CTA examination, assessed by ROC curves (AUC).hard clinical

Main Result

Effect estimate: AUC 0.786

Coronary CTA-derived left atrial appendage parameters, specifically the combination of LAAOA Index and LAAEF, can help predict cardiogenic stroke in patients with nonvalvular atrial fibrillation.

Implication

May support LAA parameter evaluation for stroke risk in nonvalvular AF; hypothesis-generating and requires prospective validation before clinical use.

Abstract

PURPOSE: . 179 patients with NVAF were selected and grouped according to the outbreak of acute ischemic stroke and TIA within 2 years after coronary CTA examination. Those who met the criteria for CS were selected as cases (87 patients), and those neither stroke nor TIA as controls (92 patients). LAA size of selected patients was measured and data postprocessing was performed. The differences of baseline data and LAA parameters between groups were analyzed. The impacts of BMI, hyperlipidemia, the duration of AF, the LAAOA Index, and the LAAEF on CS were assessed by binary logistic regression. The predictive abilities of LAAOA Index, LAAEF, and the combined predictor were assessed by ROC curves. RESULTS: and 38.71%, with AUC value of 0.712 and 0.734, respectively. The LAAOA Index-LAAEF combined predictor (AUC value = 0.786) was likely superior to either LAAOA Index or LAAEF. CONCLUSIONS: -VASc in guiding anticoagulation program, to reduce the incidence of embolism and bleeding events.

Discussion

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Cite This Study

Wang et al. (2020) conducted a case-control in Nonvalvular Atrial Fibrillation (n=179). Coronary CTA (LAAOA Index and LAAEF) was evaluated on Cardiogenic stroke (AUC 0.786). The LAAOA Index-LAAEF combined predictor (AUC 0.786) was superior to either LAAOA Index or LAAEF alone for predicting cardiogenic stroke in patients with nonvalvular atrial fibrillation.

synapsesocial.com/papers/6a0662ba3f8bf83a443dd914 https://doi.org/10.1155/2020/7351876