Frequent Premature Atrial Contractions as a Poor Prognostic Factor in Cryptogenic Stroke Patients with Concomitant Non-Sustained Atrial Tachycardia
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In cryptogenic stroke patients, early detection of new-onset atrial fibrillation (AF) and recurrent stroke is required to prevent poorclinical outcomes. Therefore, we investigated the predictors of new-onset AF and recurrent stroke in cryptogenic stroke patientswithout previously diagnosed AF. In total, 390 patients who were diagnosed with stroke and non-sustained atrial tachycardia(NSAT) on 24-hour Holter monitoring were followed up to assess new-onset AF and recurrent stroke. The 5-year event-free survivalas well as the predictors of recurrent stroke or new-onset AF were investigated. Based on receiver operating characteristicanalysis, frequent premature atrial contractions (PACs) were defined as PACs >44 beats/day. The median follow-up period was 35months. The composite event rate was 11.5%. In Kaplan-Meier analysis, the 5-year cumulative incidence of composite events washigher in cryptogenic stroke patients with frequent PACs than in those without frequent PACs. Multivariate analysis revealed thatcurrent smoking, increased left atrial volume index, and frequent PACs were poor prognostic predictors of composite event, andfrequent PACs were an independent poor prognostic factor of new-onset AF in cryptogenic stroke patients. Therefore, frequentPACs might be associated with poor clinical outcomes (new-onset AF and recurrent stroke) in cryptogenic stroke patients withconcomitant NSAT.
Abstract
In cryptogenic stroke patients, early detection of new-onset atrial fibrillation (AF) and recurrent stroke is required to prevent poorclinical outcomes. Therefore, we investigated the predictors of new-onset AF and recurrent stroke in cryptogenic stroke patientswithout previously diagnosed AF. In total, 390 patients who were diagnosed with stroke and non-sustained atrial tachycardia(NSAT) on 24-hour Holter monitoring were followed up to assess new-onset AF and recurrent stroke. The 5-year event-free survivalas well as the predictors of recurrent stroke or new-onset AF were investigated. Based on receiver operating characteristicanalysis, frequent premature atrial contractions (PACs) were defined as PACs >44 beats/day. The median follow-up period was 35months. The composite event rate was 11.5%. In Kaplan-Meier analysis, the 5-year cumulative incidence of composite events washigher in cryptogenic stroke patients with frequent PACs than in those without frequent PACs. Multivariate analysis revealed thatcurrent smoking, increased left atrial volume index, and frequent PACs were poor prognostic predictors of composite event, andfrequent PACs were an independent poor prognostic factor of new-onset AF in cryptogenic stroke patients. Therefore, frequentPACs might be associated with poor clinical outcomes (new-onset AF and recurrent stroke) in cryptogenic stroke patients withconcomitant NSAT.
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