Key result
Left atrial enlargement links to ~87% higher ischemic stroke risk per 10 mm, improving CHA2DS2-VASc prediction.
Why the study?
It was unknown whether markers of atrial cardiopathy, such as left atrial enlargement or excessive atrial ectopy, improve stroke risk prediction beyond traditional vascular risk factors like the CHA2DS2-VASc score.
Does the addition of left atrial enlargement and excessive atrial ectopy to the CHA2DS2-VASc score improve ischemic stroke risk prediction in community-dwelling adults aged ≥65 years?
Cohort (n=32,454)
Does the addition of left atrial enlargement and excessive atrial ectopy to the CHA2DS2-VASc score improve ischemic stroke risk prediction in community-dwelling adults aged ≥65 years?
Effect estimate: HR 1.87
p-value: p=<0.0001
Left atrial enlargement is an independent predictor of ischemic stroke in the absence of AF, and markers of atrial cardiopathy improve stroke risk prediction beyond the CHA2DS2-VASc score.
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May refine ischemic stroke risk prediction beyond CHA2DS2-VASc in adults ≥65 years; leaves open prospective validation before clinical use.
Edwards et al. (2020) conducted a cohort in Atrial cardiopathy without atrial fibrillation (n=32,454). Left atrial enlargement (LAE) and excessive atrial ectopy (EAE) vs. CHA2DS2-VASc alone was evaluated on Ischemic stroke (HR 1.87, p=<0.0001). Left atrial enlargement (per 10 mm increase) was associated with an increased 5-year risk of ischemic stroke (HR 1.87; P<0.0001) and improved risk prediction beyond the CHA2DS2-VASc score.
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