Carotid plaques and detection of atrial fibrillation in embolic stroke of undetermined source.
Details
Serval ID
serval:BIB_DF82A9F1888A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Carotid plaques and detection of atrial fibrillation in embolic stroke of undetermined source.
Journal
Neurology
ISSN
1526-632X (Electronic)
ISSN-L
0028-3878
Publication state
Published
Issued date
04/06/2019
Peer-reviewed
Oui
Volume
92
Number
23
Pages
e2644-e2652
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
To investigate the association between the presence of ipsilateral nonstenotic carotid plaques and the rate of detection of atrial fibrillation (AF) during follow-up in patients with embolic strokes of undetermined source (ESUS).
We pooled data of all consecutive ESUS patients from 3 prospective stroke registries. Multivariate stepwise regression assessed the association between the presence of nonstenotic carotid plaques and AF detection. The 10-year cumulative probabilities of AF detection were estimated by the Kaplan-Meier product limit method.
Among 777 patients followed for 2,642 patient-years, 341 (38.6%) patients had an ipsilateral nonstenotic carotid plaque. AF was detected in 112 (14.4%) patients in the overall population during follow-up. The overall rate of AF detection was 8.5% in patients with nonstenotic carotid plaques (2.9% per 100 patient-years) and 19.0% in patients without (5.0% per 100 patient-years) (unadjusted hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.37-0.84). The presence of ipsilateral nonstenotic carotid plaques was associated with lower probability for AF detection (adjusted HR 0.57, 95% CI 0.34-0.96, p = 0.03). The 10-year cumulative probability of AF detection was lower in patients with ipsilateral nonstenotic carotid plaques compared to those without (34.5%, 95% CI 21.8-47.2 vs 49.0%, 95% CI 40.4-57.6 respectively, log-rank-test: 11.8, p = 0.001).
AF is less frequently detected in ESUS patients with nonstenotic carotid plaques compared to those without.
NCT02766205.
We pooled data of all consecutive ESUS patients from 3 prospective stroke registries. Multivariate stepwise regression assessed the association between the presence of nonstenotic carotid plaques and AF detection. The 10-year cumulative probabilities of AF detection were estimated by the Kaplan-Meier product limit method.
Among 777 patients followed for 2,642 patient-years, 341 (38.6%) patients had an ipsilateral nonstenotic carotid plaque. AF was detected in 112 (14.4%) patients in the overall population during follow-up. The overall rate of AF detection was 8.5% in patients with nonstenotic carotid plaques (2.9% per 100 patient-years) and 19.0% in patients without (5.0% per 100 patient-years) (unadjusted hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.37-0.84). The presence of ipsilateral nonstenotic carotid plaques was associated with lower probability for AF detection (adjusted HR 0.57, 95% CI 0.34-0.96, p = 0.03). The 10-year cumulative probability of AF detection was lower in patients with ipsilateral nonstenotic carotid plaques compared to those without (34.5%, 95% CI 21.8-47.2 vs 49.0%, 95% CI 40.4-57.6 respectively, log-rank-test: 11.8, p = 0.001).
AF is less frequently detected in ESUS patients with nonstenotic carotid plaques compared to those without.
NCT02766205.
Keywords
Aged, Aged, 80 and over, Atrial Fibrillation/epidemiology, Carotid Artery Diseases/epidemiology, Female, Humans, Intracranial Embolism/epidemiology, Male, Middle Aged, Plaque, Atherosclerotic/epidemiology, Proportional Hazards Models, Stroke/epidemiology
Pubmed
Web of science
Open Access
Yes
Create date
31/05/2019 13:01
Last modification date
20/06/2021 17:32