Key result
Adding left atrial reservoir strain to CHA2DS2-VASc improves ischemic stroke prediction in patients without prior AF.
Why the study?
In people without prior AF or stroke, whether analyzing left atrial function and size can improve ischemic stroke prediction beyond CHA2DS2-VASc score variables was unknown.
Does the addition of echocardiographic left atrial function and size to CHA2DS2-VASc score variables improve ischemic stroke prediction in people without prevalent atrial fibrillation or stroke?
Cohort (n=4,917)
Yes
Does the addition of echocardiographic left atrial function and size to CHA2DS2-VASc score variables improve ischemic stroke prediction in people without prevalent atrial fibrillation or stroke?
Absolute Event Rate: 2.99% vs 1.42%
In individuals without prior atrial fibrillation or stroke, adding echocardiographic left atrial reservoir strain to the CHA2DS2-VASc score improves the prediction of ischemic stroke.
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Supports evaluation of left atrial strain for stroke prediction beyond CHA2DS2-VASc; leaves open prospective validation before practice change.
Maheshwari et al. (2022) conducted a cohort in Without prevalent atrial fibrillation or stroke (n=4,917). Left atrial reservoir strain assessment vs. Normal left atrial reservoir strain (highest quintile) was evaluated on Ischemic stroke (5-year cumulative incidence). In people without prior atrial fibrillation or stroke, adding left atrial reservoir strain to CHA2DS2-VASc variables improved ischemic stroke prediction and yielded a predicted net benefit.
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