Atrial Cardiopathy and Nonstenosing Large Artery Plaque in Patients With Embolic Stroke of Undetermined Source Article Swipe
Hooman Kamel
,
Lesly A. Pearce
,
George Ntaios
,
David J. Gladstone
,
Kanjana Perera
,
Risto O. Roine
,
Elena Meseguer
,
Ashkan Shoamanesh
,
Scott D. Berkowitz
,
Hardi Mundl
,
Mukul Sharma
,
Stuart J. Connolly
,
Robert G. Hart
,
Jeff S. Healey
·
YOU?
·
· 2020
· Open Access
·
· DOI: https://doi.org/10.1161/strokeaha.119.028154
YOU?
·
· 2020
· Open Access
·
· DOI: https://doi.org/10.1161/strokeaha.119.028154
Background and Purpose— Atrial cardiopathy and atherosclerotic plaque are two potential mechanisms underlying embolic strokes of undetermined source (ESUS). The relationship between these two mechanisms among ESUS patients remains unclear. A better understanding of their association may inform targeted secondary prevention strategies. Methods— We examined the association between atrial cardiopathy and atherosclerotic plaque in the NAVIGATE ESUS trial (New Approach Rivaroxaban Inhibition of Factor Xa in a Global Trial Versus ASA to Prevent Embolism in Embolic Stroke of Undetermined Source), which enrolled 7213 patients with recent ESUS during 2014 to 2017. For this analysis, we included patients with data on left atrial dimension, location of brain infarction, and cervical large artery plaque. The variables of primary interest were left atrial diameter and cervical plaque ipsilateral to brain infarction. Secondary markers of atrial cardiopathy were premature atrial contractions on Holter monitoring and newly diagnosed atrial fibrillation. For descriptive purposes, left atrial enlargement was defined as ≥4.7 cm. Multivariable logistic regression was used to examine the association between atrial cardiopathy markers and ipsilateral plaque after adjustment for age, sex, body mass index, hypertension, diabetes mellitus, current smoking, and hyperlipidemia. Results— Among 3983 eligible patients, 235 (5.9%) had left atrial enlargement, 939 (23.6%) had ipsilateral plaque, and 94 (2.4%) had both. Shared risk factors for left atrial enlargement and ipsilateral plaque were male sex, white race, hypertension, tobacco use, and coronary artery disease. Despite shared risk factors, increasing left atrial dimension was not associated with ipsilateral plaque after adjustment for covariates (odds ratio per cm, 1.1 [95% CI, 1.0–1.2]; P =0.08). We found no consistent associations between secondary markers of atrial cardiopathy and ipsilateral plaque. Conclusions— In a large population of patients with ESUS, we did not observe a notable association between atrial cardiopathy and atherosclerotic plaque, and few patients had both conditions. These findings suggest that atrial cardiopathy and atherosclerotic plaque may be distinct, nonoverlapping risk factors for stroke among ESUS patients.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1161/strokeaha.119.028154
- https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.119.028154
- OA Status
- bronze
- Cited By
- 36
- References
- 30
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2997156187
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W2997156187Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1161/strokeaha.119.028154Digital Object Identifier
- Title
-
Atrial Cardiopathy and Nonstenosing Large Artery Plaque in Patients With Embolic Stroke of Undetermined SourceWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2020Year of publication
- Publication date
-
2020-01-02Full publication date if available
- Authors
-
Hooman Kamel, Lesly A. Pearce, George Ntaios, David J. Gladstone, Kanjana Perera, Risto O. Roine, Elena Meseguer, Ashkan Shoamanesh, Scott D. Berkowitz, Hardi Mundl, Mukul Sharma, Stuart J. Connolly, Robert G. Hart, Jeff S. HealeyList of authors in order
- Landing page
-
https://doi.org/10.1161/strokeaha.119.028154Publisher landing page
- PDF URL
-
https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.119.028154Direct link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
bronzeOpen access status per OpenAlex
- OA URL
-
https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.119.028154Direct OA link when available
- Concepts
-
Medicine, Left atrial enlargement, Internal medicine, Atrial fibrillation, Cardiology, Stroke (engine), Odds ratio, Myocardial infarction, Diabetes mellitus, Body mass index, Embolism, Sinus rhythm, Mechanical engineering, Engineering, EndocrinologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
36Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 4, 2024: 5, 2023: 3, 2022: 7, 2021: 9Per-year citation counts (last 5 years)
- References (count)
-
30Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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