Abstract 15607: Impact of Left Atrial Enlargement on Incident Cardioembolic Stroke in Patients With Atrial Fibrillation With Low CHADS2 Score
It was reported that there are 2-3% per year of thromboembolic events in patients with atrial fibrillation (AF) despite low CHADS2 score (0-1). Left atrial volume index (LAVI) has been shown to be a powerful marker of clinical outcomes in patients with both AF and stroke. The aim of this study was to investigate whether LAVI in AF patients with low CHADS2 score is associated with cardioembolic stroke. We performed transthoracic and transesophageal echocardiography in 30 consecutive patients with first-ever cardioembolic stroke with CHADS2 score of ≤1 at stroke onset. We enrolled 241 paroxysmal atrial fibrillation patients with CHADS2 score of ≤1 into the present study as control. Cardioembolic stroke patients were older and had larger LAVI, lower left ventricular ejection fraction (LVEF), higher E/E’, and higher prevalence of heart failure than AF patients. Multivariate regression analysis revealed that only increased LAVI and high age were independent risk factors after adjusting confounding factors (LAVI, odds ratio per 1-SD increase, 2.40, 95% confident interval 1.434-4.393, p<0.05). Receiver Operating Characteristic analysis showed that the optimal LAVI for predicting cardioembolic stroke was determined as 43 ml/m2 (AUC 0.80, sensitivity 79%, specificity 71%). In conclusion, increased LAVI was the independent risk factor for cardioembolic stroke in AF patients with low CHADS2 score except for high age. Assessment of left atrial dysfunction may be a key process for primary prevention of cardioembolic stroke in AF patients.
Author Disclosures: M. Wanezaki: None. T. Watanabe: None. H. Tamura: None. N. Hashimoto: None. G. Yamaura: None. S. Nishiyama: None. T. Arimoto: None. H. Takahashi: None. T. Shishido: None. T. Miyamoto: None. I. Kubota: None.
- © 2016 by American Heart Association, Inc.