Why the study?
The authors sought to develop more precisely quantified risk models for predicting cardiogenic stroke risk in patients with non-valvular atrial fibrillation.
Does a combined predictive model using LAd, LVEF, SUA, and BNP accurately predict the presence of LAT or LA-SEC in patients with non-valvular atrial fibrillation?
Does a combined predictive model using LAd, LVEF, SUA, and BNP accurately predict the presence of LAT or LA-SEC in patients with non-valvular atrial fibrillation?
A predictive model incorporating left atrial diameter, ejection fraction, serum uric acid, and BNP can effectively identify non-valvular atrial fibrillation patients at high risk for cardiogenic stroke based on TEE findings.
Answers are grounded in this paper and cite their sources.
May aid LAT risk stratification in non-valvular AF; leaves open prospective validation before clinical use.
Objectives We attempted to develop more precisely quantified risk models for predicting cardiogenic stroke risk in non-valvular atrial fibrillation (NVAF) patients. Methods We conducted a case-control study, using data from hospitalized patients with AF who underwent transesophageal echocardiography at Shanghai Chest Hospital. A total of 233 high cardiogenic stroke risk patients with LAT or LA-SEC and 233 controls matched for age, sex, AF type. Results AF history, LA diameter enlargement, larger left ventricular end diastolic diameter, lower ejection fraction, greater SUA and BNP levels showed association with high stroke risk. The multivariate logistic regression analysis revealed that AF duration, LAd, LVEF, SUA and BNP were independent risk factors of the LAT/LA-SEC. We used LAd, LVEF, SUA and BNP to construct a combined predictive model for high stroke risk in NVAF patients (the area under ROC curve: 0.784; sensitivity 66.1%; specificity 76.8%; 95% CI 0.744–0.825, P<0.001). Conclusion Comprehensive evaluation of LAd, LVEF, SUA and BNP may help stratify the cardiogenic stroke risk among nonvalvular AF patients, and strengthen anticoagulation therapy.
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Song et al. (2020) studied this question.
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