Cardiovascular diseases in patients 65 years and younger with non-cardiogenic stroke

Lasek–Bal, Anetta; Gąsior, Zbigniew

doi:10.5114/aoms.2016.59929

Cited by 5 publications

(5 citation statements)

References 41 publications

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“…Atrial fibrillation (AF) is the most common arrhythmia in the clinical setting and can induce several cardiovascular complications, including stroke, heart failure, and myocardial infarction [1–4], which results in increased mortality and public health costs [5]. Structural remodelling has been observed in both clinical and experimental AF paradigms and is an important feature of the AF substrate, producing fibrosis that alters atrial tissue composition and function.…”

Section: Introductionmentioning

confidence: 99%

Increased plasma microfibrillar-associated protein 4 is associated with atrial fibrillation and more advanced left atrial remodelling

Zhang

Kou

et al. 2019

aoms

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Introduction This study aimed to evaluate the relationship of plasma microfibrillar-associated protein 4 (MFAP4) to atrial fibrillation (AF) and atrial structural remodelling. Material and methods Plasma MFAP4 levels were measured in 92 patients with AF (61 paroxysmal AF (PAF) patients and 31 persistent AF (PersAF) patients) and 71 control subjects without AF. Linear and logistic multivariate regression analyses were performed to determine the potential value of MFAP4 for predicting the incidence of AF and left atrial size. Then, plasma and atrial protein levels of MFAP4 and its association with atrial fibrosis ratio were analysed in an atrial-specific fibrosis rat model. Results There were significant differences in MFAP4 levels based on clinical group, with a gradient from control (1.71 ±0.53 ng/ml) to PAF (1.98 ±0.53 ng/ml) to PersAF (2.09 ±0.76 ng/ml) ( p < 0.01). With multivariate analyses, plasma MFAP4 was found to be an independent determinant of left atrial diameter in AF patients. In atrial fibrosis rats, both plasma MFAP4 and atrial MFAP4 protein levels increased in atrial fibrosis rats and positively correlated with atrial fibrosis severity. Conclusions Plasma MFAP4 was increased in patients with AF and was highest in those with PersAF; both plasma MFAP4 and atrial MFAP4 protein expression were directly associated with the extent of LA structural remodelling.

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Section: Introductionmentioning

confidence: 99%

Increased plasma microfibrillar-associated protein 4 is associated with atrial fibrillation and more advanced left atrial remodelling

Zhang

Kou

et al. 2019

aoms

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“…Although a number of studies have previously assessed the relationship between FHx and IMT [50], none has investigated this relationship in the absence of all TRF, and none has measured atherosclerosis burden. Because most cardiovascular events are not predicted by risk factor profiles [51], it is very important to have better methods to identify high-risk patients who would be likely to benefit most from preventive therapy.…”

Section: Discussionmentioning

confidence: 99%

Increased carotid plaque burden in patients with family medical history of premature cardiovascular events in the absence of classical risk factors

Atkins¹,

Perez²,

Spence³

et al. 2019

aoms

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IntroductionThe hypothesis that relates atherosclerosis to traditional risk factors (TRF) seems to be not as adequate as previously thought; other risk factors (RF) need to be considered to prevent atherosclerosis progression. Although a family medical history of premature cardiovascular events (FHx) has been considered the putative RF for decades, it has not been incorporated routinely into cardiovascular risk evaluation along with another RF. The objective of this study was to investigate whether FHx is associated with a higher atherosclerotic burden, measured as carotid total plaque area (TPA) in a population having no traditional RF.Material and methodsThe study included 4,351 primary care patients in Argentina. After excluding a personal history of cardiovascular disease (CVD) and TRF: hypertension, diabetes mellitus, hypercholesterolemia, smoking history, and body mass index (BMI) > 25 kg/cm2, 34 patients with FHx were identified. Compared to 56 matched controls TPA was 86% higher in FHx patients (p < 0.05). A second analysis performed in hypertensive patients but no other TRF; 32 patients with FHx were identified.ResultsCompared with 44 matched controls, TPA was 77% higher in FHx patients (p < 0.05). A final analysis using a generalized linear model with TPA progression as the response variable suggests that TPA progresses more rapidly in FHx patients compared to controls.ConclusionsThe FHx was associated with increased TPA burden and progression in the absence of other TRF. This supports ultrasound screening in FHx patients in order to detect high-risk patients who may benefit from early intervention.

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“…Competing causes of IS/TIA in AF patients, such as carotid atherosclerosis and/or cerebral small vessel disease, have been reported in approximately 25% of cases [ 28 ]. We also demonstrated that competing causes are even more common in AFl, because 56% of the patients with AFl in our cohort had more than one evident mechanism of IS.…”

Section: Discussionmentioning

confidence: 99%

Cerebrovascular accidents differ between patients with atrial flutter and patients with atrial fibrillation

et al. 2019

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IntroductionFew studies have explored the potential impact of atrial flutter (AFl) on ischaemic stroke (IS) outcome. The aim of the present study was to compare the clinical course of IS in patients with AFl and patients with atrial fibrillation (AF).Material and methodsA retrospective analysis of patients consecutively admitted to a tertiary care centre between 2013 and 2015 due to IS or transient ischaem-ic attack with permanent AFl or permanent or persistent AF was performed.ResultsThe study groups consisted of 528 patients, including 490 (92.8%) patients with AF and 38 (7.2%) patients with AFl. The mean age and prestroke CHA2DS2-VASc scores were similar between the patients with AFl and those with AF. Most IS cases in the AF group were clas-sified as cardioembolic strokes (74.9% vs. 39.5% in AFl, p < 0.01), and lacunar strokes were the most common in the AFl group (47.4% vs. 14.3% in AF, p < 0.01). The multivariable analysis revealed that the presence of AF (OR = 8.6, 95% CI: 1.2–57, p = 0.02), lacunar stroke (OR = 0.1, 95% CI: 0.03–0.31, p < 0.001), baseline Rankin scale score (OR = 16.6, 95% CI: 9.8–28), lack of prestroke therapeutic anticoagulation (OR = 6.1, 95% CI: 1.1–33), diabetes (OR = 2.9, 95% CI: 1.3–6.5, p < 0.01), chronic heart failure (OR = 14.2, 95% CI: 5.8–34, p < 0.001), and current smoking (OR = 0.92, 95% CI: 0.39–0.99, p < 0.01) were significantly associated with the stroke outcome.ConclusionsDisabling or fatal IS was observed less often in patients with AFl than in patients with AF. This finding can possibly be explained by the more frequent occurrence of lacunar strokes in the AFl group compared with that in the AF group.

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Cardiovascular diseases in patients 65 years and younger with non-cardiogenic stroke

Cited by 5 publications

References 41 publications

Increased plasma microfibrillar-associated protein 4 is associated with atrial fibrillation and more advanced left atrial remodelling

Increased plasma microfibrillar-associated protein 4 is associated with atrial fibrillation and more advanced left atrial remodelling

Increased carotid plaque burden in patients with family medical history of premature cardiovascular events in the absence of classical risk factors

Cerebrovascular accidents differ between patients with atrial flutter and patients with atrial fibrillation

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