Key result
Higher mean platelet volume and rate control are linked to increased stroke risk in AF.
Why the study?
Does rhythm control therapy compared to rate control therapy, and mean platelet volume, predict ischemic stroke or TIA in patients with non-valvular atrial fibrillation?
Observational (n=265)
Does rhythm control therapy compared to rate control therapy, and mean platelet volume, predict ischemic stroke or TIA in patients with non-valvular atrial fibrillation?
Higher mean platelet volume and a rate control strategy are independent predictors of stroke or TIA in patients with non-valvular atrial fibrillation.
Answers are grounded in this paper and cite their sources.
Elevated MPV or rate control may predict stroke in nonvalvular AF; hypothesis-generating from cohort data and needs prospective validation.
The aim of this study was to determine the impact of mean platelet volume (MPV) on the strategy for treatment of atrial fibrillation (AF) with respect to stroke prevention. MPV was analyzed in 265 patients with AF who were undergoing treatment using rhythm or rate control. The primary endpoint was ischemic stroke or a transient ischemic attack (TIA) event. Kaplan-Meier analysis revealed a significantly higher stroke rate in the rate control group compared to the rhythm control group. A significantly higher stroke rate was observed in the higher tertile MPV group (≥7.9 fL) compared to the lower tertile MPV group (<7.3 fL). When the MPV cut-off level was set to 7.85 fL using the receiver operating characteristic curve, the sensitivity was 80.0% and the specificity was 70.4% for differentiating between the group with stroke and the group without stroke. In the Cox proportional hazard analysis, after adjusting for sex, treatment strategy for AF, high MPV level, antithrombotic treatment, and high CHADS2 score, higher MPV, rate control strategy for treatment of AF, and high CHADS2 score were found to be independent predictors of stroke risk. In addition, patients with AF who were treated using rate control had high stroke risk with an MPV over 7.85 fL and high CHADS2 score. The results of this study demonstrate that the MPV and the rate control strategy for treatment of AF were predictive markers for stroke; its predictive power for stroke was independent of female sex and high CHADS2 score in patients with AF.
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Hong et al. (2013) conducted an observational in Atrial fibrillation (n=265). Mean platelet volume and rate control strategy vs. Lower mean platelet volume and rhythm control strategy was evaluated on Ischemic stroke or a transient ischemic attack (TIA) event. Higher mean platelet volume (cut-off 7.85 fL yielded 80.0% sensitivity and 70.4% specificity) and rate control strategy were independent predictors of stroke risk in patients with atrial fibrillation.
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