Abstract 11212: Left Atrial Volume Index Predicts Recurrence of Stroke in Patients With Non-Sustained Atrial Tachycardia
Introduction: NSAT is known to appear more frequently in patients with paroxysmal AF. Additionally enlarged LA is considered to be an independent risk factor for newly diagnosed AF. We investigated the relationship between non-sustained atrial tachycardia (NSAT) and stroke recurrence and the risk factors that may predict stroke recurrence in stroke patients where 24-hour Holter monitoring documented NSAT without paroxysmal AF.
Hypothesis: We hypothesized that those patients who presented with NSAT and enlarged LA would have a higher incidence of stroke recurrence.
Methods: 214 patients (102 males, mean 70±11 years) with acute ischemic stroke and NSAT were subject to 24-hour Holter monitoring. During follow-up patients were assessed for stroke recurrence and echocardiographic parameters.
Results: During a mean follow-up period of 36±34 months, the recurrence rate of stroke was 11.8% (25 of 214). Those patients with recurrence had a larger LA diameter (34.73±5.04 vs. 40.64±3.45mm, p<0.001), LA volume index (LAVI, 22.56±5.86vs. 33.81±7.80 ml/m2, p<0.001and increased E/E’ (12.27±4.86 vs. 14.49±4.38, p=0.032) compared to patients without recurrence (n=189). A Kaplan-Meier survival rate was significantly lower in patients with enlarged LA size (LAVI>28 mm3/m2) compared with patients without enlarged LA size (LAVI≤28 mm3/m2) (p<0.001 by log-rank test). Cox regression analysis revealed that left atrial volume index hazard ratio (HR: 1.148, 95% CI: 1.092-1.206, p<0.001) was an independent predictor for stroke recurrence in patients with NSAT. Areas under the Receiver Operating Characteristics (ROC) curve of LAVI for recurrence of stroke was 0.876 (95% CI: 0.791-0.960, p<0.001).
Conclusions: In patients with acute ischemic stroke and NSAT, increased LAVI predicts an increased risk of stroke recurrence. This study supports the potential use of anticoagulants in stroke patients with NSAT and increased LAVI without documented AF to reduce recurrent stroke.
Author Disclosures: H. Chung: None. P. Min: None. Y. Yoon: None. B. Lee: None. B. Hong: None. S. Rim: None. H. Kwon: None. E. Choi: None. J. Kim: None.
- © 2014 by American Heart Association, Inc.