Key result
High early VCAM-1 is linked to ~813% higher odds of LAE in acute ischemic stroke.
Why the study?
It was unclear whether left atrial enlargement, as a marker of atrial myopathy, is associated with a distinct profile of circulating inflammatory markers in acute ischemic stroke patients.
Is left atrial enlargement associated with a specific profile of circulating inflammatory markers in patients with acute ischemic stroke?
Observational (n=143)
Is left atrial enlargement associated with a specific profile of circulating inflammatory markers in patients with acute ischemic stroke?
In patients with acute ischemic stroke, left atrial enlargement is independently associated with higher levels of circulating inflammatory markers VCAM-1 and sST2 within the first 48 hours.
Supports LAE-inflammation link in acute stroke; hypothesis-generating and should not yet change practice.
Background: The inflammatory process underlying atrial myopathy may affect the inflammatory response activated in acute ischemic stroke (AIS). Objectives: We aimed to assess whether left atrial enlargement (LAE) as a marker of atrial myopathy is associated with a different profile of circulating inflammatory markers in AIS patients. Methods: . A multiple logistic regression model was performed to detect an independent association between the area under the curve (AUC) of these markers and LAE. Results: We included 143 patients. Of them, 85 (59.4%) had LAE. On univariable analysis, we found that patients with LAE had higher soluble form suppression of tumorigenicity 2 (sST2), soluble tumor necrosis factor receptor I (sTNFR1), and vascular cellular adhesion molecule-1 (VCAM-1) AUC, were older, mostly female, had a higher National Institutes of Health Stroke Scale (NIHSS) score and blood glucose level at admission, had more often hypertension, and a cardioembolic source of AIS, such as atrial fibrillation, while they were less frequently current smokers and had a lower rate of tandem occlusion than patients without LAE. On multivariable analysis, we found that among circulating inflammatory markers, only high VCAM-1 (OR: 9.13, 95% CI: 3.21-25.9) and sST2 (OR: 3.40, 95% CI: 1.68-6.86) AUC remained associated with LAE. Conclusions: High VCAM-1 and sST2 levels within the first 48 h are associated with LAE in AIS patients.
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Fontaine et al. (2023) conducted an observational in Acute ischemic stroke (n=143). Left atrial enlargement (LAE) vs. No left atrial enlargement was evaluated on Independent association between the area under the curve (AUC) of circulating inflammatory markers and LAE (OR 9.13, 95% CI 3.21-25.9). High VCAM-1 (OR 9.13; 95% CI 3.21-25.9) and sST2 (OR 3.40; 95% CI 1.68-6.86) levels within the first 48 hours are independently associated with left atrial enlargement in acute ischemic stroke.
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