Key result
Elevated atrial cardiomyopathy markers like PTFV1 predict ~29% higher ischemic stroke risk.
Why the study?
Atrial cardiomyopathy may play an essential role in thrombosis and ischemic stroke, but the value of cardiomyopathy markers for predicting ischemic stroke risk required quantification.
Do atrial cardiomyopathy markers predict incident ischemic stroke in the general population without prior stroke?
Meta-Analysis (n=262,504)
Do atrial cardiomyopathy markers predict incident ischemic stroke in the general population without prior stroke?
Atrial cardiomyopathy markers, including ECG, echocardiographic, and serum biomarkers, are significantly associated with an increased risk of incident ischemic stroke and may aid in risk stratification.
Answers are grounded in this paper and cite their sources.
May aid primary-prevention stroke risk stratification; confirms marker associations in large meta-analysis.
BACKGROUND AND PURPOSE: Growing evidence suggests that atrial cardiomyopathy may play an essential role in thrombosis and ischemic stroke. The aim of this systematic review and meta-analysis was to quantify the values of cardiomyopathy markers for predicting ischemic stroke risk. METHODS: PubMed, Embase, and the Cochrane Library were searched for longitudinal cohort studies evaluating the association between cardiomyopathy markers and incident ischemic stroke risk. RESULTS: We included 25 cohort studies examining electrocardiographic, structural, functional, and serum biomarkers of atrial cardiomyopathy involving 262,504 individuals. P-terminal force in the precordial lead V1 (PTFV1) was found to be an independent predictor of ischemic stroke as both a categorical variable (HR 1.29, CI 1.06-1.57) and a continuous variable (HR 1.14, CI 1.00-1.30). Increased maximum P-wave area (HR 1.14, CI 1.06-1.21) and mean P-wave area (HR 1.12, CI 1.04-1.21) were also associated with an increased risk of ischemic stroke. Left atrial (LA) diameter was independently associated with ischemic stroke as both a categorical variable (HR 1.39, CI 1.06-1.82) and a continuous variable (HR 1.20, CI 1.06-1.35). LA reservoir strain independently predicted the risk of incident ischemic stroke (HR 0.88, CI 0.84-0.93). N-terminal pro-brain natriuretic peptide (NT-proBNP) was also associated with incident ischemic stroke risk, both as a categorical variable (HR 2.37, CI 1.61-3.50) and continuous variable (HR 1.42, CI 1.19-1.70). CONCLUSION: Atrial cardiomyopathy markers, including electrocardiographic markers, serum markers, LA structural and functional markers, can be used to stratify the risk of incident ischemic stroke.
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Guo et al. (2023) conducted a meta-analysis in General population without stroke at baseline (n=262,504). Atrial cardiomyopathy markers (e.g., PTFV1, LA diameter, NT-proBNP) vs. Lowest levels of markers (categorical) or continuous comparison was evaluated on Incident ischemic stroke (HR 1.29, 95% CI 1.06-1.57). Elevated atrial cardiomyopathy markers, including PTFV1 (HR 1.29), left atrial diameter (HR 1.39), and NT-proBNP (HR 2.37), independently predicted an increased risk of incident ischemic stroke.
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