Asymptomatic atrial fibrillation increased stroke risk compared to sinus rhythm (HR 2.150; 95% CI 1.523-3.003), but no direct correlation was detected between AF burden and stroke risk (p=0.874).
Meta-Analysis
Does the burden of asymptomatic atrial fibrillation directly correlate with the risk of stroke?
While asymptomatic AF is associated with a higher risk of stroke compared to sinus rhythm, the specific burden of asymptomatic AF does not appear to directly correlate with stroke risk based on this meta-analysis.
Effect estimate: HR 2.150 (95% CI 1.523-3.003)
p-value: p=0.874
BACKGROUND: Contributory evidence on a direct association between asymptomatic atrial fibrillation (AF) burden and thromboembolic events is conflicting and contradictory. The aim of the article is to gather evidence available for a direct correlation between burden and stroke. METHODS: A literature search was performed to capture studies reporting data on the impact of asymptomatic AF burden on the risk of stroke. Data was then extracted from each included study including burden of AF, hazard ratio (HR) for stroke, and CHADS2 score. A random effects meta-analysis was carried out on the log-transformed HRs for different subgroups of AF burden. A meta-regression was performed on the two variables: burden of asymptomatic AF and CHADS2 score. RESULTS: The random-effect pooled analysis performed on a single subgroup of the six studies reporting data on HR, showed a HR of 2.150 (95% CI 1.523-3.003) for stroke during asymptomatic AF compared to sinus rhythm. At univariate meta-regression, no correlation was detected between burden of asymptomatic AF and HR for stroke (p-value 0,874). When CHADS2 score was included in the regression model as a covariate, no significant association was detected (p-value 0,939). CONCLUSION: A direct correlation between burden of asymptomatic AF and HR for stroke cannot be detected in our pooled analysis. However, due to the limitations acknowledged in the analysis, our findings need to be confirmed in large cohort studies.
Proietti et al. (Sat,) conducted a meta-analysis in Asymptomatic atrial fibrillation. Asymptomatic atrial fibrillation vs. Sinus rhythm was evaluated on Stroke (HR 2.150, 95% CI 1.523-3.003, p=0.874). Asymptomatic atrial fibrillation increased stroke risk compared to sinus rhythm (HR 2.150; 95% CI 1.523-3.003), but no direct correlation was detected between AF burden and stroke risk (p=0.874).