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Neurology: Biomarkers for the detection of atrial fibrillation after stroke: a systematic review and meta-analysis

 Last Update: 2021-09-29
 Source: Internet
 Author: User

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Cardiac infarction, atrial fibrillation is usually caused by (AF) caused, resulting in about 1/3 of the ischemic brain stroke occurs, can cause serious stroke
.

Anticoagulation is very effective in reducing the risk of stroke in patients with AF.

Stroke

Long-term heart monitoring can help detect more atrial fibrillation
.

Wearing a ring recorder for 30 days can detect atrial fibrillation in 16.

Recently, researchers have used systematic reviews and meta-analysis to determine clinical, electrocardiogram, and blood biomarkers related to AF detection one year after ischemic stroke/TIA

Variables associated with an increased likelihood of atrial fibrillation were age (OR 3.
26, 95%CI 2.
354.
54), female (OR 1.
47, 95%CI 1.
23-1.
77), and history of heart failure (OR 2.
56, 95%CI 1.
87-3.
49) ), hypertension (OR 1.
42, 95%CI 1.
15-1.
75) or ischemic heart disease (OR 1.
80, 95%CI 1.
34-2.
42), higher modified Rankin classification (OR 6.
13, 95%CI 2.
93~12.
84) Or the National Institutes of Health Stroke Scale score (OR 2.
50, 95%CI 1.
64~3.
81), no obvious carotid artery/intracranial artery stenosis (OR 3.
23, 95%CI 1.
14~9.
11), non-smoker (OR 1.
93, 95 %CI 1.
48~2.
51), statin therapy (OR 2.
07, 95%CI 1.
143.
73), stroke as an indicator diagnosis (OR 1.
59, 95%CI 1.
17~2.
18), systolic blood pressure (OR 1.
61, 95%CI 1.
16- 2.
22), intravenous thrombolysis (OR 2.
40, 95%CI 1.
83-3.
16), atrioventricular block (OR 2.
12, 95%CI 1.
08-4.
17), left ventricular hypertrophy (OR 2.
21, 95%CI 1.
03-4.
74) , Atrial premature beats (OR 3.
90, 95%CI 1.
74-8.
74), maximum P wave duration (OR 3.
19, 95%CI 1.
40-7.
25), PR interval (OR 2.
32, 95%CI 1.
11-4.
83), P wave dispersion Degree (OR 7.
79, 95%CI 4.
16-14.
61), P wave index (OR 3.
44, 95%CI 1.
87-6.
32), QTc interval (OR 3.
68, 95%CI 1.
63-8.
28), brain natriuretic peptide (OR 13.
73 , 95% CI 3.
31-57.
07) and high-density lipoprotein cholesterol (OR 1.
49 , 95% CI 1.
171.
88) concentration
.
Variables associated with reduced likelihood are minimum P wave duration (OR 0.
53, 95% CI 0.
290.
98), LDL-cholesterol (OR 0.
73, 95% CI 0.
57-0.
93) and triglycerides (OR 0.
51, 95% CI 0.
41-0.
64) Concentration
.

Variables associated with an increased likelihood of atrial fibrillation were age (OR 3.
26, 95%CI 2.
354.
54), female (OR 1.
47, 95%CI 1.
23-1.
77), and history of heart failure (OR 2.
56, 95%CI 1.
87-3.
49) ), hypertension (OR 1.
42, 95%CI 1.
15-1.
75) or ischemic heart disease (OR 1.
80, 95%CI 1.
34-2.
42), higher modified Rankin classification (OR 6.
13, 95%CI 2.
93~12.
84) Or the National Institutes of Health Stroke Scale score (OR 2.
50, 95%CI 1.
64~3.
81), no obvious carotid artery/intracranial artery stenosis (OR 3.
23, 95%CI 1.
14~9.
11), non-smoker (OR 1.
93, 95 %CI 1.
48~2.
51), statin therapy (OR 2.
07, 95%CI 1.
143.
73), stroke as an indicator diagnosis (OR 1.
59, 95%CI 1.
17~2.
18), systolic blood pressure (OR 1.
61, 95%CI 1.
16- 2.
22), intravenous thrombolysis (OR 2.
40, 95%CI 1.
83-3.
16), atrioventricular block (OR 2.
12, 95%CI 1.
08-4.
17), left ventricular hypertrophy (OR 2.
21, 95%CI 1.
03-4.
74) , Atrial premature beats (OR 3.
90, 95%CI 1.
74-8.
74), maximum P wave duration (OR 3.
19, 95%CI 1.
40-7.
25), PR interval (OR 2.
32, 95%CI 1.
11-4.
83), P wave dispersion Degree (OR 7.
79, 95%CI 4.
16-14.
61), P wave index (OR 3.
44, 95%CI 1.
87-6.
32), QTc interval (OR 3.
68, 95%CI 1.
63-8.
28), brain natriuretic peptide (OR 13.
73 , 95% CI 3.
31-57.
07) and high-density lipoprotein cholesterol (OR 1.
49 , 95% CI 1.
171.
88) concentration
.

Age (OR 3.
26, 95%CI 2.
354.
54), female (OR 1.
47, 95%CI 1.
23-1.
77), history of heart failure (OR 2.
56, 95%CI 1.
87-3.
49), hypertension (OR 1.
42, 95%CI 1.
15-1.
75) or ischemic heart disease (OR 1.
80, 95%CI 1.
34-2.
42), higher modified Rankin classification (OR 6.
13, 95%CI 2.
93-12.
84) or National Institutes of Health Stroke Scale score ( OR 2.
50, 95%CI 1.
64~3.
81), no obvious carotid artery/intracranial artery stenosis (OR 3.
23, 95%CI 1.
14~9.
11), non-smoker (OR 1.
93, 95%CI 1.
48~2.
51), statin therapy (OR 2.
07, 95%CI 1.
143.
73), stroke as the index diagnosis (OR 1.
59, 95%CI 1.
17~2.
18), systolic blood pressure (OR 1.
61, 95%CI 1.
16-2.
22), intravenous thrombolytic therapy (OR 2.
40, 95%CI 1.
83-3.
16), atrioventricular block (OR 2.
12, 95%CI 1.
08-4.
17), left ventricular hypertrophy (OR 2.
21, 95%CI 1.
03-4.
74), atrial premature beats (OR 3.
90, 95%CI 1.
74-8.
74), maximum P wave time limit (OR 3.
19, 95%CI 1.
40-7.
25), PR interval (OR 2.
32, 95%CI 1.
11-4.
83), P wave dispersion (OR 7.
79, 95%CI 4.
16-14.
61) ), P wave index (OR 3.
44, 95%CI 1.
87-6.
32), QTc interval (OR 3.
68, 95%CI 1.
63-8.
28), brain natriuretic peptide (OR 13.
73, 95%CI 3.
31-57.
07) and high density Lipoprotein cholesterol (OR 1.
49, 95% CI 1.
171.
88) concentration to diagnose cholesterol

Variables associated with reduced likelihood are minimum P wave duration (OR 0.
53, 95% CI 0.
290.
98), LDL-cholesterol (OR 0.
73, 95% CI 0.
57-0.
93) and triglycerides (OR 0.
51, 95% CI 0.
41-0.
64) Concentration
.

Minimum P wave duration (OR 0.
53, 95% CI 0.
290.
98), LDL-cholesterol (OR 0.
73, 95% CI 0.
57-0.
93) and triglyceride (OR 0.
51, 95% CI 0.
41-0.
64) concentration
.

The study identified multimodal biomarkers that can help guide patient selection for cardiac monitoring after ischemic stroke/transient ischemic attack (TIA)
.

Their prognostic utility should be prospectively evaluated based on the results of atrial fibrillation detection and recurrent stroke

The study identified multimodal biomarkers that can help guide patient selection for cardiac monitoring after ischemic stroke/transient ischemic attack (TIA)

https://n.
neurology.
org/content/early/2021/09/09/WNL.
0000000000012769.
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