Abstract
Objectives
Understanding the link between markers of cardiac injury and atrial fibrillation (AF)
detected after stroke (AFDAS) may help refine stroke risk stratification and therapeutic
approaches in AFDAS.
Materials and methods
We retrospectively analyzed 988 adult patients admitted for acute ischemic stroke
and transient ischemic attack, who presented within 4.5 h from last known well. Pertinent
clinical variables including features of neurogenic cardiac injury (so-called stroke
heart syndrome [SHS]) as well as electrocardiographic and echocardiographic markers
of cardiac dysfunction, and AF status (no AF n = 574; known AF n = 311; AFDAS; n = 103) were collected. Multivariable logistic regression was used to determine the
independent associations of variables with AFDAS.
Results
A total of 264 (26.7%) subjects fulfilled criteria for SHS. Of these, 174 of had SHS
features other than AFDAS (non-AF SHS). Among 677 subjects without known AF, presence
of non-AF SHS was associated with a 5-fold odds of AFDAS (OR 5.0, 95%-CI 3.1–8.0,
p < 0.001). After adjustment, non-AF SHS (OR 3.2, 95%-CI 1.6–6.4, p = 0.001) and the left atrial volume index (OR 1.04, 95%-CI 1.01–1.08, p = 0.004) remained independently associated with AFDAS.
Conclusions
The presence of non-AF SHS features and the left atrial volume index were independently
associated with AFDAS indicating diverse mechanisms relating to new onset AF. A better
understanding of the links between these markers and AFDAS may help uncover potentially
modifiable risk factors for AFDAS as well as aid treatment decisions in patients at
risk for new onset AF and ischemic stroke.
Key Words
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Article info
Publication history
Published online: March 24, 2022
Accepted:
March 7,
2022
Received:
January 31,
2022
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106445
Copyright
© 2022 Elsevier Inc. All rights reserved.
