Cargando…

Retrospective Study of 1255 Non-Anticoagulated Patients with Nonvalvular Atrial Fibrillation to Determine the Risk of Ischemic Stroke Associated with Left Atrial Spontaneous Echo Contrast on Transesophageal Echocardiography

BACKGROUND: Left atrial spontaneous echo contrast (LASEC) is associated with an increased risk of stroke in patients with nonvalvular atrial fibrillation (NVAF). Therefore, a tool that identifies the risk of LASEC in non-anticoagulated patients with NVAF may be helpful for stroke risk stratification...

Descripción completa

Detalles Bibliográficos
Autores principales: Liu, Kesen, Li, Yukun, Wu, Kui, Li, Junlei, Zhu, Yong, Guo, Fei, Bai, Rong, Dong, Jianzeng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8672647/
https://www.ncbi.nlm.nih.gov/pubmed/34893576
http://dx.doi.org/10.12659/MSM.934795
_version_ 1784615396926554112
author Liu, Kesen
Li, Yukun
Wu, Kui
Li, Junlei
Zhu, Yong
Guo, Fei
Bai, Rong
Dong, Jianzeng
author_facet Liu, Kesen
Li, Yukun
Wu, Kui
Li, Junlei
Zhu, Yong
Guo, Fei
Bai, Rong
Dong, Jianzeng
author_sort Liu, Kesen
collection PubMed
description BACKGROUND: Left atrial spontaneous echo contrast (LASEC) is associated with an increased risk of stroke in patients with nonvalvular atrial fibrillation (NVAF). Therefore, a tool that identifies the risk of LASEC in non-anticoagulated patients with NVAF may be helpful for stroke risk stratification and early stroke prevention in these patients. The aim of this retrospective study was to establish a novel risk score model to determine the risk of ischemic stroke associated with LASEC on transesophageal echocardiography (TEE). MATERIAL/METHODS: This study retrospectively and consecutively enrolled 1255 non-anticoagulated patients with NVAF who underwent TEE prior to catheter ablation or left atrial appendage occlusion. Most importantly, a novel nomogram was developed using a logistic regression model to predict the risk of LASEC. RESULTS: A nomogram was established for LASEC prediction which included 5 independent risk factors determined by multivariable logistic regression analysis: increased age, non-paroxysmal atrial fibrillation, previous stroke/transient ischemic attack, congestive heart failure, and left atrial enlargement. The receiver operating characteristic curve analysis showed that the area under the curve (AUC) of the novel risk score model was 0.879 (95% confidence interval: 0.849–0.909, P<0.001). Compared with the CHA2DS2-VASc score, the novel risk score model had a better predictive power (AUC: 0.879 vs 0.617, P<0.001). CONCLUSIONS: This novel risk score model effectively predicted the presence of LASEC in non-anticoagulated patients with NVAF.
format Online
Article
Text
id pubmed-8672647
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher International Scientific Literature, Inc.
record_format MEDLINE/PubMed
spelling pubmed-86726472022-01-11 Retrospective Study of 1255 Non-Anticoagulated Patients with Nonvalvular Atrial Fibrillation to Determine the Risk of Ischemic Stroke Associated with Left Atrial Spontaneous Echo Contrast on Transesophageal Echocardiography Liu, Kesen Li, Yukun Wu, Kui Li, Junlei Zhu, Yong Guo, Fei Bai, Rong Dong, Jianzeng Med Sci Monit Clinical Research BACKGROUND: Left atrial spontaneous echo contrast (LASEC) is associated with an increased risk of stroke in patients with nonvalvular atrial fibrillation (NVAF). Therefore, a tool that identifies the risk of LASEC in non-anticoagulated patients with NVAF may be helpful for stroke risk stratification and early stroke prevention in these patients. The aim of this retrospective study was to establish a novel risk score model to determine the risk of ischemic stroke associated with LASEC on transesophageal echocardiography (TEE). MATERIAL/METHODS: This study retrospectively and consecutively enrolled 1255 non-anticoagulated patients with NVAF who underwent TEE prior to catheter ablation or left atrial appendage occlusion. Most importantly, a novel nomogram was developed using a logistic regression model to predict the risk of LASEC. RESULTS: A nomogram was established for LASEC prediction which included 5 independent risk factors determined by multivariable logistic regression analysis: increased age, non-paroxysmal atrial fibrillation, previous stroke/transient ischemic attack, congestive heart failure, and left atrial enlargement. The receiver operating characteristic curve analysis showed that the area under the curve (AUC) of the novel risk score model was 0.879 (95% confidence interval: 0.849–0.909, P<0.001). Compared with the CHA2DS2-VASc score, the novel risk score model had a better predictive power (AUC: 0.879 vs 0.617, P<0.001). CONCLUSIONS: This novel risk score model effectively predicted the presence of LASEC in non-anticoagulated patients with NVAF. International Scientific Literature, Inc. 2021-12-11 /pmc/articles/PMC8672647/ /pubmed/34893576 http://dx.doi.org/10.12659/MSM.934795 Text en © Med Sci Monit, 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Clinical Research
Liu, Kesen
Li, Yukun
Wu, Kui
Li, Junlei
Zhu, Yong
Guo, Fei
Bai, Rong
Dong, Jianzeng
Retrospective Study of 1255 Non-Anticoagulated Patients with Nonvalvular Atrial Fibrillation to Determine the Risk of Ischemic Stroke Associated with Left Atrial Spontaneous Echo Contrast on Transesophageal Echocardiography
title Retrospective Study of 1255 Non-Anticoagulated Patients with Nonvalvular Atrial Fibrillation to Determine the Risk of Ischemic Stroke Associated with Left Atrial Spontaneous Echo Contrast on Transesophageal Echocardiography
title_full Retrospective Study of 1255 Non-Anticoagulated Patients with Nonvalvular Atrial Fibrillation to Determine the Risk of Ischemic Stroke Associated with Left Atrial Spontaneous Echo Contrast on Transesophageal Echocardiography
title_fullStr Retrospective Study of 1255 Non-Anticoagulated Patients with Nonvalvular Atrial Fibrillation to Determine the Risk of Ischemic Stroke Associated with Left Atrial Spontaneous Echo Contrast on Transesophageal Echocardiography
title_full_unstemmed Retrospective Study of 1255 Non-Anticoagulated Patients with Nonvalvular Atrial Fibrillation to Determine the Risk of Ischemic Stroke Associated with Left Atrial Spontaneous Echo Contrast on Transesophageal Echocardiography
title_short Retrospective Study of 1255 Non-Anticoagulated Patients with Nonvalvular Atrial Fibrillation to Determine the Risk of Ischemic Stroke Associated with Left Atrial Spontaneous Echo Contrast on Transesophageal Echocardiography
title_sort retrospective study of 1255 non-anticoagulated patients with nonvalvular atrial fibrillation to determine the risk of ischemic stroke associated with left atrial spontaneous echo contrast on transesophageal echocardiography
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8672647/
https://www.ncbi.nlm.nih.gov/pubmed/34893576
http://dx.doi.org/10.12659/MSM.934795
work_keys_str_mv AT liukesen retrospectivestudyof1255nonanticoagulatedpatientswithnonvalvularatrialfibrillationtodeterminetheriskofischemicstrokeassociatedwithleftatrialspontaneousechocontrastontransesophagealechocardiography
AT liyukun retrospectivestudyof1255nonanticoagulatedpatientswithnonvalvularatrialfibrillationtodeterminetheriskofischemicstrokeassociatedwithleftatrialspontaneousechocontrastontransesophagealechocardiography
AT wukui retrospectivestudyof1255nonanticoagulatedpatientswithnonvalvularatrialfibrillationtodeterminetheriskofischemicstrokeassociatedwithleftatrialspontaneousechocontrastontransesophagealechocardiography
AT lijunlei retrospectivestudyof1255nonanticoagulatedpatientswithnonvalvularatrialfibrillationtodeterminetheriskofischemicstrokeassociatedwithleftatrialspontaneousechocontrastontransesophagealechocardiography
AT zhuyong retrospectivestudyof1255nonanticoagulatedpatientswithnonvalvularatrialfibrillationtodeterminetheriskofischemicstrokeassociatedwithleftatrialspontaneousechocontrastontransesophagealechocardiography
AT guofei retrospectivestudyof1255nonanticoagulatedpatientswithnonvalvularatrialfibrillationtodeterminetheriskofischemicstrokeassociatedwithleftatrialspontaneousechocontrastontransesophagealechocardiography
AT bairong retrospectivestudyof1255nonanticoagulatedpatientswithnonvalvularatrialfibrillationtodeterminetheriskofischemicstrokeassociatedwithleftatrialspontaneousechocontrastontransesophagealechocardiography
AT dongjianzeng retrospectivestudyof1255nonanticoagulatedpatientswithnonvalvularatrialfibrillationtodeterminetheriskofischemicstrokeassociatedwithleftatrialspontaneousechocontrastontransesophagealechocardiography