Coronary CTA to Investigate Predictive Value of Left Atrial Appendage for Cardiogenic Stroke in Patients with Nonvalvular Atrial Fibrillation
Purpose. To investigate the predictive value of changes in LAA size and function for cardiogenic stroke (CS) in patients with NVAF by coronary CTA examination. Materials and Method. 179 patients with NVAF were selected and grouped according to the outbreak of acute ischemic stroke and TIA within 2 y...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Hindawi Limited
2020-01-01
|
Series: | BioMed Research International |
Online Access: | http://dx.doi.org/10.1155/2020/7351876 |
id |
doaj-d68f551cf72d4aacb8bfc90e34930537 |
---|---|
record_format |
Article |
spelling |
doaj-d68f551cf72d4aacb8bfc90e349305372020-11-25T04:02:56ZengHindawi LimitedBioMed Research International2314-61332314-61412020-01-01202010.1155/2020/73518767351876Coronary CTA to Investigate Predictive Value of Left Atrial Appendage for Cardiogenic Stroke in Patients with Nonvalvular Atrial FibrillationRunrong Wang0Chunhong Hu1Zheng Li2Shuai Zhang3Wei Li4Hongling Hou5Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province 215006, ChinaDepartment of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province 215006, ChinaDepartment of Radiology, Medical Imaging Center, The Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province 225001, ChinaDepartment of Neurology, The Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province 225001, ChinaDepartment of Cardiology, The Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province 225001, ChinaDepartment of Neurology, The Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province 225001, ChinaPurpose. To investigate the predictive value of changes in LAA size and function for cardiogenic stroke (CS) in patients with NVAF by coronary CTA examination. Materials and Method. 179 patients with NVAF were selected and grouped according to the outbreak of acute ischemic stroke and TIA within 2 years after coronary CTA examination. Those who met the criteria for CS were selected as cases (87 patients), and those neither stroke nor TIA as controls (92 patients). LAA size of selected patients was measured and data postprocessing was performed. The differences of baseline data and LAA parameters between groups were analyzed. The impacts of BMI, hyperlipidemia, the duration of AF, the LAAOA Index, and the LAAEF on CS were assessed by binary logistic regression. The predictive abilities of LAAOA Index, LAAEF, and the combined predictor were assessed by ROC curves. Results. Proportions of BMI≥25, prevalence of hyperlipidemia, duration of AF, and LAAODmax, LAAODmin, LAAOA, LAAVmax, and LAAVmin with their correction index were greater in cases than controls. The LAAEF was lower in cases than that in controls. The binary logistic regression model showed an increase in LAAOA Index (P=0.005) and a decrease in LAAEF (P<0.001) were independent risk factors for CS. ROC curve analysis showed that the optimal cutoff values of LAAOA Index and LAAEF to predict CS were 3.16 cm2/m2 and 38.71%, with AUC value of 0.712 and 0.734, respectively. The LAAOA Index-LAAEF combined predictor (AUC value=0.786) was likely superior to either LAAOA Index or LAAEF. Conclusions. Coronary CTA can provide additional valuable parameters, as a by-product of coronary artery assessment without additional radiation dose, for the risk assessment of CS in patients with NVAF. Coronary CTA may make up for the limitation of single indicator of CHA2DS2-VASc in guiding anticoagulation program, to reduce the incidence of embolism and bleeding events.http://dx.doi.org/10.1155/2020/7351876 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Runrong Wang Chunhong Hu Zheng Li Shuai Zhang Wei Li Hongling Hou |
spellingShingle |
Runrong Wang Chunhong Hu Zheng Li Shuai Zhang Wei Li Hongling Hou Coronary CTA to Investigate Predictive Value of Left Atrial Appendage for Cardiogenic Stroke in Patients with Nonvalvular Atrial Fibrillation BioMed Research International |
author_facet |
Runrong Wang Chunhong Hu Zheng Li Shuai Zhang Wei Li Hongling Hou |
author_sort |
Runrong Wang |
title |
Coronary CTA to Investigate Predictive Value of Left Atrial Appendage for Cardiogenic Stroke in Patients with Nonvalvular Atrial Fibrillation |
title_short |
Coronary CTA to Investigate Predictive Value of Left Atrial Appendage for Cardiogenic Stroke in Patients with Nonvalvular Atrial Fibrillation |
title_full |
Coronary CTA to Investigate Predictive Value of Left Atrial Appendage for Cardiogenic Stroke in Patients with Nonvalvular Atrial Fibrillation |
title_fullStr |
Coronary CTA to Investigate Predictive Value of Left Atrial Appendage for Cardiogenic Stroke in Patients with Nonvalvular Atrial Fibrillation |
title_full_unstemmed |
Coronary CTA to Investigate Predictive Value of Left Atrial Appendage for Cardiogenic Stroke in Patients with Nonvalvular Atrial Fibrillation |
title_sort |
coronary cta to investigate predictive value of left atrial appendage for cardiogenic stroke in patients with nonvalvular atrial fibrillation |
publisher |
Hindawi Limited |
series |
BioMed Research International |
issn |
2314-6133 2314-6141 |
publishDate |
2020-01-01 |
description |
Purpose. To investigate the predictive value of changes in LAA size and function for cardiogenic stroke (CS) in patients with NVAF by coronary CTA examination. Materials and Method. 179 patients with NVAF were selected and grouped according to the outbreak of acute ischemic stroke and TIA within 2 years after coronary CTA examination. Those who met the criteria for CS were selected as cases (87 patients), and those neither stroke nor TIA as controls (92 patients). LAA size of selected patients was measured and data postprocessing was performed. The differences of baseline data and LAA parameters between groups were analyzed. The impacts of BMI, hyperlipidemia, the duration of AF, the LAAOA Index, and the LAAEF on CS were assessed by binary logistic regression. The predictive abilities of LAAOA Index, LAAEF, and the combined predictor were assessed by ROC curves. Results. Proportions of BMI≥25, prevalence of hyperlipidemia, duration of AF, and LAAODmax, LAAODmin, LAAOA, LAAVmax, and LAAVmin with their correction index were greater in cases than controls. The LAAEF was lower in cases than that in controls. The binary logistic regression model showed an increase in LAAOA Index (P=0.005) and a decrease in LAAEF (P<0.001) were independent risk factors for CS. ROC curve analysis showed that the optimal cutoff values of LAAOA Index and LAAEF to predict CS were 3.16 cm2/m2 and 38.71%, with AUC value of 0.712 and 0.734, respectively. The LAAOA Index-LAAEF combined predictor (AUC value=0.786) was likely superior to either LAAOA Index or LAAEF. Conclusions. Coronary CTA can provide additional valuable parameters, as a by-product of coronary artery assessment without additional radiation dose, for the risk assessment of CS in patients with NVAF. Coronary CTA may make up for the limitation of single indicator of CHA2DS2-VASc in guiding anticoagulation program, to reduce the incidence of embolism and bleeding events. |
url |
http://dx.doi.org/10.1155/2020/7351876 |
work_keys_str_mv |
AT runrongwang coronaryctatoinvestigatepredictivevalueofleftatrialappendageforcardiogenicstrokeinpatientswithnonvalvularatrialfibrillation AT chunhonghu coronaryctatoinvestigatepredictivevalueofleftatrialappendageforcardiogenicstrokeinpatientswithnonvalvularatrialfibrillation AT zhengli coronaryctatoinvestigatepredictivevalueofleftatrialappendageforcardiogenicstrokeinpatientswithnonvalvularatrialfibrillation AT shuaizhang coronaryctatoinvestigatepredictivevalueofleftatrialappendageforcardiogenicstrokeinpatientswithnonvalvularatrialfibrillation AT weili coronaryctatoinvestigatepredictivevalueofleftatrialappendageforcardiogenicstrokeinpatientswithnonvalvularatrialfibrillation AT honglinghou coronaryctatoinvestigatepredictivevalueofleftatrialappendageforcardiogenicstrokeinpatientswithnonvalvularatrialfibrillation |
_version_ |
1715059977731702784 |