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Ischemic Stroke in Non-Gender-Related CHA 2 DS 2-VA Score 0~1 Is Associated With H 2 FPEF Score Among the Patients With Atrial Fibrillation

Authors
 Min Kim  ;  Hee Tae Yu  ;  Tae-Hoon Kim  ;  Dae-In Lee  ;  Jae-Sun Uhm  ;  Young Dae Kim  ;  Hyo Suk Nam  ;  Boyoung Joung  ;  Moon-Hyoung Lee  ;  Ji Hoe Heo  ;  Hui-Nam Pak 
Citation
 FRONTIERS IN CARDIOVASCULAR MEDICINE, Vol.8 : 791112, 2022-02 
Journal Title
FRONTIERS IN CARDIOVASCULAR MEDICINE
Issue Date
2022-02
Keywords
CHA2DS2-VA score ; H2FPEF score ; atrial fibrillation ; atrial myopathy ; stroke
Abstract
Background: Ischemic strokes (ISs) can appear even in non-gender-related CHA2DS2-VA scores 0~1 patients with atrial fibrillation (AF). We explored the determinants associated with IS development among the patients with non-gender-related CHA2DS2-VA score 0~1 AF.

Methods and results: In this single-center retrospective registry data for AF catheter ablation (AFCA), we included 1,353 patients with AF (24.7% female, median age 56 years, and paroxysmal AF 72.6%) who had non-gender-related CHA2DS2-VA score 0~1, normal left ventricular (LV) systolic function, and available H2FPEF score. Among those patients, 113 experienced IS despite a non-gender-related CHA2DS2-VA score of 0~1. All included patients underwent AFCA, and we evaluated the associated factors with IS in non-gender-related CHA2DS2-VA score 0~1 AF. Patients with ISs in this study had a lower estimated glomerular filtration rate (eGFR) (p < 0.001) and LV ejection fraction (LVEF; p = 0.017), larger LA diameter (p < 0.001), reduced LA appendage peak velocity (p < 0.001), and a higher baseline H2FPEF score (p = 0.018) relative to those without ISs. Age [odds ratio (OR) 1.11 (1.07-1.17), p < 0.001, Model 1] and H2FPEF score as continuous [OR 1.31 (1.03-1.67), p = 0.028, Model 2] variable were independently associated with ISs by multivariate analysis. Moreover, the eGFR was independently associated with IS at low CHA2DS2-VA scores in both Models 1 and 2. AF recurrence was significantly higher in patients with IS (log-rank p < 0.001) but not in those with high H2FPEF scores (log-rank p = 0.079), respectively.

Conclusions: Among the patients with normal LVEF and non-gender-related CHA2DS2-VA score 0~1 AF, the high H2FPEF score, and increasing age were independently associated with IS development (ClinicalTrials.gov Identifier: NCT02138695).
Files in This Item:
T202200934.pdf Download
DOI
10.3389/fcvm.2021.791112
Appears in Collections:
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
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Yu, Hee Tae(유희태) ORCID logo https://orcid.org/0000-0002-6835-4759
Lee, Moon-Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188353
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