Interatrial block in prediction of all-cause mortality after first-ever ischemic stroke

Research output: Contribution to journalArticle

Abstract

Background: Interatrial block (IAB) is an ECG indicator of atrial fibrosis related to atrial remodeling and thrombus formation thus leading to embolic stroke and increasing mortality. We aimed to assess weather IAB predicted all-cause mortality during 10 years after ischemic stroke. Methods: The study sample comprised 235 patients (median age 74 (interquartile range 25-75% 65-81) years, 95 female) included in the Lund Stroke Register in 2001-2002, who had sinus rhythm ECGs at stroke admission. IAB was defined as a P-wave duration ≥120 ms without = partial IAB (n = 56) or with = advanced IAB (n = 41) biphasic morphology (±) in the inferior ECG leads. All-cause mortality was assessed via linkage with the Swedish Causes of Death Register. Results: During follow-up 126 patients died (54%). Advanced IAB, but not partial, was associated with all-cause mortality in univariate Cox regression analysis (hazard ratio (HR) 1.98, 95% CI 1.27-3.09, p = 0.003). After adjustment for age, gender, severity of stroke measured by NIHSS scale and smoking status in patients without additional comorbidities advanced IAB independently predicted all-cause mortality (HR 7.89, 95% CI 2.01-30.98, p = 0.003), while in patients with comorbidities it did not (HR 1.01 95% CI 0.59-1.72, p = 0.966). Conclusion: Advanced IAB predicted all-cause mortality after ischemic stroke, but mostly in patients without additional cardiovascular comorbidities.

Details

Authors
Organisations
External organisations
  • Saint Petersburg State University
  • Skåne University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems

Keywords

  • All-cause mortality, Atrial fibrosis, ECG, Interatrial block, Ischemic stroke
Original languageEnglish
Article number37
JournalBMC Cardiovascular Disorders
Volume19
Issue number1
Publication statusPublished - 2019 Feb 11
Publication categoryResearch
Peer-reviewedYes