Dados do Trabalho

Título

Assessment of the presence of indicators of atrial heart disease in patients with ischemic stroke without previously diagnosed atrial fibrillation.

Resumo

Introduction: Ischemic Stroke may have paroxysmal atrial fibrillation as a potential risk factor, which existed before the ischemic event, but remained undiagnosed even with the etiological investigation. Objective: To study whether the presence of markers of atrial heart disease in patients with stroke has a statistical correlation with the identification of AF at follow-up. Methodology: Retrospective longitudinal study with evaluation of data in electronic medical records of patients hospitalized for stroke from 2014 to 2021. A total of 872 patients with complete data in medical records and without known AF were analyzed. The markers of atriopathies studied were LA size, reduced ejection fraction, presence of intraventricular septal fibrosis, interatrial septal aneurysm or atrial appendage thrombus identified on echocardiography. Using Holter, we analyzed the presence of arrhythmias, as well as the presence of extrasystoles. We also tabulated data such as age, image topography, main comorbidities and failure to use antithrombotics in the population studied. Results: We identified that LA greater than or equal to 42 mm, age greater than or equal to 70 years, the presence of septal aneurysm and NHISS greater than or equal to 6 at admission are variables with statistical significance associated with the risk of developing atrial fibrillation in the follow-up. With these variables, it was possible to structure a risk score for the diagnosis of AF in the follow-up, in which the patient who scores equal to or more than 2 points has a risk of AF in the follow-up 5 times greater. Conclusions: Based on the present study, we concluded that in the sample of stroke patients from the Instituto de Neurologia de Curitiba, without known AF before the event, the presence of markers of atrial heart disease showed a positive correlation with the detection of AF at follow-up. In addition, it was possible to apply an AF risk score which could be validated in larger samples in future studies.