Journal article
Predictors of thromboembolism in atrial fibrillation: II. Echocardiographic features of patients at risk. The Stroke Prevention in Atrial Fibrillation Investigators
Annals of internal medicine, Vol.116(1), pp.6-12
01/01/1992
DOI: 10.7326/0003-4819-116-1-6
PMID: 1727097
Abstract
OBJECTIVE: To identify echocardiographic predictors of arterial thromboembolism in patients with nonrheumatic atrial fibrillation and to determine whether these add to clinical variables for risk stratification.DESIGNCohort study of patients assigned to placebo in a randomized clinical trial.SETTINGFive hundred sixty-eight inpatients and outpatients with nonrheumatic atrial fibrillation assigned to placebo therapy at 15 U.S. medical centers from 1987 to 1989 in the Stroke Prevention in Atrial Fibrillation study. Patients were followed for a mean of 1.3 years.MEASUREMENTSM-mode and two-dimensional (2-D) echocardiograms performed at study entry and interpreted by local cardiologists. The predictive value of 14 echocardiographic variables for later ischemic stroke or systemic embolism was assessed by multivariate analysis. MAIN RESULTS: Left ventricular dysfunction from 2-D echocardiograms (P = 0.003) and the size of the left atrium from M-mode echocardiograms (P = 0.02) were the strongest independent predictors of later thromboembolism. Multivariate analysis of these two independent echocardiographic predictors with the three independent clinical predictors of thromboembolism (history of hypertension, recent congestive heart failure, previous thromboembolism) identified 26% of the cohort with a low risk for thromboembolism (1.0% per year; 95% Cl, 0.2% to 4.0%). Compared with risk stratification using clinical variables alone, echocardiographic results altered thromboembolic risk stratification in 18% of the entire cohort and in 38% of those without clinical risk factors.
Details
- Title: Subtitle
- Predictors of thromboembolism in atrial fibrillation: II. Echocardiographic features of patients at risk. The Stroke Prevention in Atrial Fibrillation Investigators
- Creators
- Stroke Prevention in Atrial Fibrillation Investigators
- Contributors
- Harold P Adams Jr (Contributor) - University of Iowa, Neurology
- Resource Type
- Journal article
- Publication Details
- Annals of internal medicine, Vol.116(1), pp.6-12
- DOI
- 10.7326/0003-4819-116-1-6
- PMID
- 1727097
- ISSN
- 0003-4819
- eISSN
- 1539-3704
- Language
- English
- Date published
- 01/01/1992
- Academic Unit
- Neurology; Iowa Neuroscience Institute
- Record Identifier
- 9984020865402771
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