P-Wave Indices and Risk of Ischemic Stroke: A Systematic Review and Meta-Analysis. Issue 8 (August 2017)

• Record Type: Journal Article
• Authors: He, Jinli; Tse, Gary; Korantzopoulos, Panagiotis; Letsas, Konstantinos P.; Ali-Hasan-Al-Saegh, Sadeq; Kamel, Hooman; Li, Guangping; Lip, Gregory Y.H.; Liu, Tong
• Is Part Of: Stroke. Volume 48:Issue 8(2017)
• Publication Date: 2017-08
• Subjects: atrial fibrillation -- electrocardiography -- heart atria -- odds ratio -- stroke; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.117.017293
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : 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. Abstract : Supplemental Digital Content is available in the text.