TY - JOUR
T1 - P-Wave Indices and Risk of Ischemic Stroke
T2 - A Systematic Review and Meta-Analysis
AU - He, Jinli
AU - Tse, Gary
AU - Korantzopoulos, Panagiotis
AU - Letsas, Konstantinos P
AU - Ali-Hasan-Al-Saegh, Sadeq
AU - Kamel, Hooman
AU - Li, Guangping
AU - Lip, Gregory Y H
AU - Liu, Tong
N1 - This article has been found as a 'Free Version' from the Publisher on July 26th 2018. When the access to the article closes, please notify vbn@aub.aau.dk”
PY - 2017
Y1 - 2017
N2 - BACKGROUND AND PURPOSE: Atrial cardiomyopathy is associated with an increased risk of ischemic stroke. P-wave terminal force in lead V1, P-wave duration, and maximum P-wave area are electrocardiographic parameters that have been used to assess left atrial abnormalities related to developing atrial fibrillation. The aim of this systematic review and meta-analysis was to examine their values for predicting ischemic stroke risk.METHODS: PubMed and EMBASE databases were searched until December 2016 for studies that evaluated the association between P-wave indices and stroke risk. Both fixed- and random-effects models were used to calculate the overall effect estimates.RESULTS: Ten studies examining P-wave terminal force in lead V1, P-wave duration, and maximum P-wave area were included. P-wave terminal force in lead V1 was found to be an independent predictor of stroke as both a continuous variable (odds ratio [OR] per 1 SD change, 1.18; 95% confidence interval [CI], 1.12-1.25; P<0.0001) and categorical variable (OR, 1.59; 95% CI, 1.10-2.28; P=0.01). P-wave duration was a significant predictor of incident ischemic stroke when analyzed as a categorical variable (OR, 1.86; 95% CI, 1.37-2.52; P<0.0001) but not when analyzed as a continuous variable (OR, 1.05; 95% CI, 0.98-1.13; P=0.15). Maximum P-wave area also predicted the risk of incident ischemic stroke (OR per 1 SD change, 1.10; 95% CI, 1.04-1.17).CONCLUSIONS: P-wave terminal force in lead V1, P-wave duration, and maximum P-wave area are useful electrocardiographic markers that can be used to stratify the risk of incident ischemic stroke.
AB - BACKGROUND AND PURPOSE: Atrial cardiomyopathy is associated with an increased risk of ischemic stroke. P-wave terminal force in lead V1, P-wave duration, and maximum P-wave area are electrocardiographic parameters that have been used to assess left atrial abnormalities related to developing atrial fibrillation. The aim of this systematic review and meta-analysis was to examine their values for predicting ischemic stroke risk.METHODS: PubMed and EMBASE databases were searched until December 2016 for studies that evaluated the association between P-wave indices and stroke risk. Both fixed- and random-effects models were used to calculate the overall effect estimates.RESULTS: Ten studies examining P-wave terminal force in lead V1, P-wave duration, and maximum P-wave area were included. P-wave terminal force in lead V1 was found to be an independent predictor of stroke as both a continuous variable (odds ratio [OR] per 1 SD change, 1.18; 95% confidence interval [CI], 1.12-1.25; P<0.0001) and categorical variable (OR, 1.59; 95% CI, 1.10-2.28; P=0.01). P-wave duration was a significant predictor of incident ischemic stroke when analyzed as a categorical variable (OR, 1.86; 95% CI, 1.37-2.52; P<0.0001) but not when analyzed as a continuous variable (OR, 1.05; 95% CI, 0.98-1.13; P=0.15). Maximum P-wave area also predicted the risk of incident ischemic stroke (OR per 1 SD change, 1.10; 95% CI, 1.04-1.17).CONCLUSIONS: P-wave terminal force in lead V1, P-wave duration, and maximum P-wave area are useful electrocardiographic markers that can be used to stratify the risk of incident ischemic stroke.
KW - Journal Article
UR - https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.117.017293
U2 - 10.1161/STROKEAHA.117.017293
DO - 10.1161/STROKEAHA.117.017293
M3 - Review article
C2 - 28679858
SN - 0039-2499
VL - 48
SP - 2066
EP - 2072
JO - Stroke
JF - Stroke
IS - 8
ER -