Key result
Premature atrial complexes predict ~316% higher AF risk in ischemic and cryptogenic stroke patients.
Why the study?
Studies assessing premature atrial complexes as risk factors for AF in ischemic stroke patients have yielded controversial results.
Do premature atrial complexes predict atrial fibrillation in ischemic stroke patients?
Do premature atrial complexes predict atrial fibrillation in ischemic stroke patients?
Premature atrial complexes, particularly frequent PACs, are strong predictors of future and asymptomatic atrial fibrillation in patients with ischemic stroke.
Answers are grounded in this paper and cite their sources.
May support enhanced AF monitoring in stroke patients with PACs; leaves open whether it improves detection or outcomes.
BACKGROUND AND PURPOSE: Several studies have explored premature atrial complexes (PACs) as high-risk factors for atrial fibrillation (AF) in ischemic stroke patients; however, the results were controversial. The aim of this systematic review and meta-analysis was to examine whether PACs can predict AF in ischemic stroke patients. METHODS: We comprehensively searched the published literature in PubMed, Embase, and Wiley-Cochrane library databases from inception through August 18, 2020. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were analyzed by the fixed-effect model or the random-effect model based on heterogeneity. RESULTS: We identified 12 eligible studies including 2340 stroke patients with a mean age of 65.9 years. PACs were highly associated with AF occurrence in stroke (pooled OR: 4.16, 95% CI: 3.06-5.65) and cryptogenic stroke patients (pooled OR: 3.72, 95% CI: 2.66-5.20). Subgroup analysis showed PAC presence and frequent PACs were correlated with stroke in AF patients (pooled OR: 3.72, 95% CI: 1.65-8.36 and pooled OR: 5.12, 95% CI: 3.12-8.41, respectively). Frequent PACs were identified as the risks for asymptomatic AF (OR: 6.18, 95% CI: 3.23-11.83) and future AF occurrence (OR: 3.71, 95% CI: 2.62-5.26) in stroke patients. The definition of frequent PACs was inconsistent, and was >70 beats/24 h based on Holter monitoring. CONCLUSIONS: PACs confer high risks for asymptomatic AF and future AF occurrence in stroke patients.
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Tao et al. (2021) studied this question. Premature atrial complexes significantly predicted atrial fibrillation in overall ischemic stroke (OR 4.16, 95% CI 3.06-5.65) and cryptogenic stroke patients (OR 3.72, 95% CI 2.66-5.20).
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