Abstract
Background: Atrial fibrillation (AF) is a major cause of cardio-embolism in patients with stroke
and transient ischemic attack (TIA). Insertable cardiac monitors (ICM) make long-term
monitoring for AF possible, but limited health care resources make patient selection
important. AF is associated with atherosclerosis and markers of this could potentially
be used to guide AF monitoring. Methods and Results: One-hundred fourteen TIA-patients without AF were thoroughly monitored for AF with
ECG, 72-hour Holter monitoring and ICM with a median monitoring time of 2.2 years.
Patients with AF (n = 18) were significantly older than patients without AF (age 71.1
versus 64.4 years, P = .008) but were otherwise similar in regards to comorbidities. AF patients had significantly
thicker carotid intima-media and also more often presence of carotid plaques than
patients without AF, but no difference was found after adjusting for age and sex.
No difference in noncontrast cardiac CT calculated coronary artery calcium score was
found between the 2 groups. Serum biomarkers did not differ between groups, except
for brain natriuretic peptide (BNP), where patients with BNP in the upper tertile
were more likely to have AF than patients with BNP in the lowest tertile, odds ratio
5.96 (95% confidence interval 1.04-34.07, P = .045). Conclusions: Carotid intima-media thickness and coronary artery calcium score were poor predictors
of AF in patients with TIA. Apart from BNP, the examined biomarkers (hs-CRP, MR-proADM,
c-TnI, copeptin) had no predictive value, but larger scale studies are needed to confirm
these findings.
Key Words
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Article info
Publication history
Published online: January 29, 2020
Accepted:
December 29,
2019
Received in revised form:
December 21,
2019
Received:
October 12,
2019
Footnotes
Funding: This study was funded by Odense University Hospital and The Department of Cardiology, The University of Southern Denmark, The Region of Southern Denmark (jr. nr 12/7623), The Bønnelykke Foundation, The A.P. Møller Foundation, The Danish Heart Foundation (2017-R111-A7746) and The Familien Hede Nielsens Foundation.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104643
Copyright
© 2020 Elsevier Inc. All rights reserved.
