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Frequent Premature Atrial Contractions as a Poor Prognostic Factor in Cryptogenic Stroke Patients with Concomitant Non-Sustained Atrial Tachycardia

 Jung Joon Cha  ;  Kyung Yul Lee  ;  Hyemoon Chung  ;  In Soo Kim  ;  Eui Young Choi  ;  Pil Ki Min  ;  Young Won Yoon  ;  Byoung Kwon Lee  ;  Bum Kee Hong  ;  Se Joong Rim  ;  Hyuck Moon Kwon  ;  Jong Youn Kim 
 YONSEI MEDICAL JOURNAL, Vol.61(11) : 965-969, 2020-11 
Journal Title
Issue Date
Aged, 80 and over ; Atrial Fibrillation / complications ; Atrial Fibrillation / diagnosis* ; Atrial Fibrillation / physiopathology ; Atrial Premature Complexes / complications* ; Atrial Premature Complexes / diagnosis ; Cerebral Infarction / complications* ; Cerebral Infarction / epidemiology ; Cerebral Infarction / prevention & control ; Electrocardiography, Ambulatory / adverse effects ; Female ; Heart Rate / physiology* ; Humans ; Incidence ; Male ; Middle Aged ; Prognosis ; Republic of Korea / epidemiology ; Stroke / etiology ; Tachycardia
Cryptogenic stroke ; atrial fibrillation ; clinical outcome ; premature atrial contraction ; recurrent stroke
In cryptogenic stroke patients, early detection of new-onset atrial fibrillation (AF) and recurrent stroke is required to prevent poor clinical outcomes. Therefore, we investigated the predictors of new-onset AF and recurrent stroke in cryptogenic stroke patients without 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 survival as well as the predictors of recurrent stroke or new-onset AF were investigated. Based on receiver operating characteristic analysis, frequent premature atrial contractions (PACs) were defined as PACs >44 beats/day. The median follow-up period was 35 months. The composite event rate was 11.5%. In Kaplan-Meier analysis, the 5-year cumulative incidence of composite events was higher in cryptogenic stroke patients with frequent PACs than in those without frequent PACs. Multivariate analysis revealed that current smoking, increased left atrial volume index, and frequent PACs were poor prognostic predictors of composite event, and frequent PACs were an independent poor prognostic factor of new-onset AF in cryptogenic stroke patients. Therefore, frequent PACs might be associated with poor clinical outcomes (new-onset AF and recurrent stroke) in cryptogenic stroke patients with concomitant NSAT.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Hyuck Moon(권혁문) ORCID logo https://orcid.org/0000-0001-9901-5015
Kim, In-Soo(김인수) ORCID logo https://orcid.org/0000-0003-2801-5514
Kim, Jong Youn(김종윤) ORCID logo https://orcid.org/0000-0001-7040-8771
Min, Pil Ki(민필기) ORCID logo https://orcid.org/0000-0001-7033-7651
Yoon, Young Won(윤영원) ORCID logo https://orcid.org/0000-0002-0907-0350
Lee, Kyung Yul(이경열) ORCID logo https://orcid.org/0000-0001-5585-7739
Lee, Byoung Kwon(이병권) ORCID logo https://orcid.org/0000-0001-9259-2776
Rim, Se Joong(임세중) ORCID logo https://orcid.org/0000-0002-7631-5581
Cha, Jung-Joon(차정준) ORCID logo https://orcid.org/0000-0002-8299-1877
Choi, Eui Young(최의영) ORCID logo https://orcid.org/0000-0003-3732-0190
Hong, Bum Kee(홍범기) ORCID logo https://orcid.org/0000-0002-6456-0184
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