Your browser doesn't support javascript.
loading
Carotid Atherosclerosis and Stroke in Atrial Fibrillation: The Atherosclerosis Risk in Communities Study.
Bekwelem, Wobo; Jensen, Paul N; Norby, Faye L; Soliman, Elsayed Z; Agarwal, Sunil K; Lip, Gregory Y H; Pan, Wei; Folsom, Aaron R; Longstreth, W T; Alonso, Alvaro; Heckbert, Susan R; Chen, Lin Y.
Afiliação
  • Bekwelem W; From the University of Minnesota, Minneapolis (W.B., F.L.N., W.P., A.R.F., A.A., L.Y.C.); University of Washington, Seattle (P.N.J., W.T.L., S.R.H.); Wake Forest University, Winston-Salem, NC (E.Z.S.); Mt. Sinai School of Medicine, New York, NY (S.K.A.); and University of Birmingham Centre for Cardi
  • Jensen PN; From the University of Minnesota, Minneapolis (W.B., F.L.N., W.P., A.R.F., A.A., L.Y.C.); University of Washington, Seattle (P.N.J., W.T.L., S.R.H.); Wake Forest University, Winston-Salem, NC (E.Z.S.); Mt. Sinai School of Medicine, New York, NY (S.K.A.); and University of Birmingham Centre for Cardi
  • Norby FL; From the University of Minnesota, Minneapolis (W.B., F.L.N., W.P., A.R.F., A.A., L.Y.C.); University of Washington, Seattle (P.N.J., W.T.L., S.R.H.); Wake Forest University, Winston-Salem, NC (E.Z.S.); Mt. Sinai School of Medicine, New York, NY (S.K.A.); and University of Birmingham Centre for Cardi
  • Soliman EZ; From the University of Minnesota, Minneapolis (W.B., F.L.N., W.P., A.R.F., A.A., L.Y.C.); University of Washington, Seattle (P.N.J., W.T.L., S.R.H.); Wake Forest University, Winston-Salem, NC (E.Z.S.); Mt. Sinai School of Medicine, New York, NY (S.K.A.); and University of Birmingham Centre for Cardi
  • Agarwal SK; From the University of Minnesota, Minneapolis (W.B., F.L.N., W.P., A.R.F., A.A., L.Y.C.); University of Washington, Seattle (P.N.J., W.T.L., S.R.H.); Wake Forest University, Winston-Salem, NC (E.Z.S.); Mt. Sinai School of Medicine, New York, NY (S.K.A.); and University of Birmingham Centre for Cardi
  • Lip GY; From the University of Minnesota, Minneapolis (W.B., F.L.N., W.P., A.R.F., A.A., L.Y.C.); University of Washington, Seattle (P.N.J., W.T.L., S.R.H.); Wake Forest University, Winston-Salem, NC (E.Z.S.); Mt. Sinai School of Medicine, New York, NY (S.K.A.); and University of Birmingham Centre for Cardi
  • Pan W; From the University of Minnesota, Minneapolis (W.B., F.L.N., W.P., A.R.F., A.A., L.Y.C.); University of Washington, Seattle (P.N.J., W.T.L., S.R.H.); Wake Forest University, Winston-Salem, NC (E.Z.S.); Mt. Sinai School of Medicine, New York, NY (S.K.A.); and University of Birmingham Centre for Cardi
  • Folsom AR; From the University of Minnesota, Minneapolis (W.B., F.L.N., W.P., A.R.F., A.A., L.Y.C.); University of Washington, Seattle (P.N.J., W.T.L., S.R.H.); Wake Forest University, Winston-Salem, NC (E.Z.S.); Mt. Sinai School of Medicine, New York, NY (S.K.A.); and University of Birmingham Centre for Cardi
  • Longstreth WT; From the University of Minnesota, Minneapolis (W.B., F.L.N., W.P., A.R.F., A.A., L.Y.C.); University of Washington, Seattle (P.N.J., W.T.L., S.R.H.); Wake Forest University, Winston-Salem, NC (E.Z.S.); Mt. Sinai School of Medicine, New York, NY (S.K.A.); and University of Birmingham Centre for Cardi
  • Alonso A; From the University of Minnesota, Minneapolis (W.B., F.L.N., W.P., A.R.F., A.A., L.Y.C.); University of Washington, Seattle (P.N.J., W.T.L., S.R.H.); Wake Forest University, Winston-Salem, NC (E.Z.S.); Mt. Sinai School of Medicine, New York, NY (S.K.A.); and University of Birmingham Centre for Cardi
  • Heckbert SR; From the University of Minnesota, Minneapolis (W.B., F.L.N., W.P., A.R.F., A.A., L.Y.C.); University of Washington, Seattle (P.N.J., W.T.L., S.R.H.); Wake Forest University, Winston-Salem, NC (E.Z.S.); Mt. Sinai School of Medicine, New York, NY (S.K.A.); and University of Birmingham Centre for Cardi
  • Chen LY; From the University of Minnesota, Minneapolis (W.B., F.L.N., W.P., A.R.F., A.A., L.Y.C.); University of Washington, Seattle (P.N.J., W.T.L., S.R.H.); Wake Forest University, Winston-Salem, NC (E.Z.S.); Mt. Sinai School of Medicine, New York, NY (S.K.A.); and University of Birmingham Centre for Cardi
Stroke ; 47(6): 1643-6, 2016 06.
Article em En | MEDLINE | ID: mdl-27217511
ABSTRACT
BACKGROUND AND

PURPOSE:

Whether consideration of carotid intima-media thickness (cIMT) and carotid plaque would improve risk prediction of ischemic stroke in persons with atrial fibrillation (AF) is unknown. The purpose of this study was to assess the improvement in risk prediction of stroke by adding cIMT and carotid plaque to the CHA2DS2-VASc (variables age, heart failure, hypertension, diabetes mellitus, myocardial infarction, and peripheral arterial disease) score.

METHODS:

We included participants from the Atherosclerosis Risk in Communities (ARIC) study (mean age, 63 years) who developed AF within 5 years after carotid measurement, were not on warfarin, and had no prior stroke at AF diagnosis. AF was ascertained from study ECGs and diagnosis codes, and stroke was physician adjudicated. Multivariable Cox models were used to assess association between carotid indices and ischemic stroke. Improvement in 10-year risk prediction of stroke was assessed by the C-statistic, net reclassification improvement, and relative integrated discrimination improvement.

RESULTS:

There were 81 (11.2%) stroke events that occurred among 724 participants with AF during a mean follow-up of 8.5 years. Increased cIMT and presence of carotid plaque were significantly associated with increased stroke risk. The addition of cIMT+plaque to the CHA2DS2-VASc score marginally increased the C-statistic (95% confidence interval) from 0.685 (0.623-0.747) to 0.698 (0.638-0.759). The net reclassification improvement and integrated discrimination improvement for cIMT+plaque were 0.091 (95% confidence interval, 0.012-0.170) and 0.101 (95% confidence interval, 0.002-0.226), respectively.

CONCLUSIONS:

Increased cIMT and presence of carotid plaque are associated with increased risk of ischemic stroke in individuals with AF. Furthermore, they may improve risk prediction of stroke, over and above the CHA2DS2-VASc score.
Assuntos
Palavras-chave
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fibrilação Atrial / Doenças das Artérias Carótidas / Acidente Vascular Cerebral / Placa Aterosclerótica / Espessura Intima-Media Carotídea Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2016 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fibrilação Atrial / Doenças das Artérias Carótidas / Acidente Vascular Cerebral / Placa Aterosclerótica / Espessura Intima-Media Carotídea Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2016 Tipo de documento: Article