Dataset Information

Initial In-Hospital Visit-to-Visit Heart Rate Variability Is Associated with Higher Risk of Atrial Fibrillation in Patients with Acute Ischemic Stroke.

ABSTRACT:

Background

To evaluate the association between the visit-to-visit heart rate variability and the risk of atrial fibrillation (AF) in acute ischemic stroke (AIS).

Methods

We analyzed the data of 8179 patients with AIS. Patients without AF on 12-lead electrocardiography underwent further 24 h Holter monitoring. They were categorized into four subgroups according to the visit-to-visit heart rate variability expressed as the coefficient of variation in heart rate (HR-CV). Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using the HR-CV < 0.08 subgroup as a reference.

Results

The adjusted OR of paroxysmal AF was 1.866 (95% CI = 1.205-2.889) for the HR-CV ≥ 0.08 and <0.10 subgroup, 1.889 (95% CI = 1.174-3.038) for the HR-CV ≥ 0.10 and <0.12 subgroup, and 5.564 (95% CI = 3.847-8.047) for the HR-CV ≥ 0.12 subgroup. The adjusted OR of persistent AF was 2.425 (95% CI = 1.921-3.062) for the HR-CV ≥ 0.08 and <0.10 subgroup, 4.312 (95% CI = 3.415-5.446) for the HR-CV ≥ 0.10 and <0.12 subgroup, and 5.651 (95% CI = 4.586-6.964) for the HR-CV ≥ 0.12 subgroup.

Conclusions

HR-CV can facilitate the identification of patients with AIS at a high risk of paroxysmal AF.

SUBMITTER: Lee JD

PROVIDER: S-EPMC9918220 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Publications

Initial In-Hospital Visit-to-Visit Heart Rate Variability Is Associated with Higher Risk of Atrial Fibrillation in Patients with Acute Ischemic Stroke.

Lee Jiann-Der JD Kuo Ya-Wen YW Lee Chuan-Pin CP Huang Yen-Chu YC Lee Meng M Lee Tsong-Hai TH

Journal of clinical medicine 20230129 3

<h4>Background</h4>To evaluate the association between the visit-to-visit heart rate variability and the risk of atrial fibrillation (AF) in acute ischemic stroke (AIS).<h4>Methods</h4>We analyzed the data of 8179 patients with AIS. Patients without AF on 12-lead electrocardiography underwent further 24 h Holter monitoring. They were categorized into four subgroups according to the visit-to-visit heart rate variability expressed as the coefficient of variation in heart rate (HR-CV). Odds ratios ...[more]

PMID: 36769700

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Project description:BackgroundAtrial fibrillation (AF) is prevalent in patients with type 2 diabetes mellitus (T2DM). Glycemic variability (GV) is associated with risk of micro- and macrovascular diseases. However, whether the GV can increase the risk of AF remains unknown.MethodsThe cohort study used a database from National Taiwan University Hospital, a tertiary medical center in Taiwan. Between 2014 and 2019, a total of 27,246 adult patients with T2DM were enrolled for analysis. Each individual was assessed to determine the coefficients of variability of fasting glucose (FGCV) and HbA1c variability score (HVS). The GV parameters were categorized into quartiles. Multivariate Cox regression models were employed to estimate the relationship between the GV parameters and the risk of AF, transient ischemic accident (TIA)/ischemic stroke and mortality in patients with T2DM.ResultsThe incidence rates of AF and TIA/ischemic stroke were 21.31 and 13.71 per 1000 person-year respectively. The medium follow-up period was 70.7 months. In Cox regression model with full adjustment, the highest quartile of FGCV was not associated with increased risk of AF [Hazard ratio (HR): 1.12, 95% confidence interval (CI) 0.96-1.29, p = 0.148] or TIA/ischemic stroke (HR: 1.04, 95% CI 0.83-1.31, p = 0.736), but was associated with increased risk of total mortality (HR: 1.33, 95% CI 1.12-1.58, p < 0.001) and non-cardiac mortality (HR: 1.41, 95% CI 1.15-1.71, p < 0.001). The highest HVS was significantly associated with increased risk of AF (HR: 1.29, 95% CI 1.12-1.50, p < 0.001), total mortality (HR: 2.43, 95% CI 2.03-2.90, p < 0.001), cardiac mortality (HR: 1.50, 95% CI 1.06-2.14, p = 0.024) and non-cardiac mortality (HR: 2.80, 95% CI 2.28-3.44, p < 0.001) but was not associated with TIA/ischemic stroke (HR: 0.98, 95% CI 0.78-1.23, p = 0.846). The Kaplan-Meier analysis showed significantly higher risk of AF, cardiac and non-cardiac mortality according to the magnitude of GV (log-rank test, p < 0.001).ConclusionsOur data demonstrate that high GV is independently associated with the development of new-onset AF in patients with T2DM. The benefit of maintaining stable glycemic levels to improve clinical outcomes warrants further studies.

Dataset Information

Initial In-Hospital Visit-to-Visit Heart Rate Variability Is Associated with Higher Risk of Atrial Fibrillation in Patients with Acute Ischemic Stroke.

Background

Methods

Results

Conclusions

Publications

Initial In-Hospital Visit-to-Visit Heart Rate Variability Is Associated with Higher Risk of Atrial Fibrillation in Patients with Acute Ischemic Stroke.

Similar Datasets

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