Ischemic Stroke in Non-Gender-Related CHADS-VA Score 0~1 Is Associated With HFPEF Score Among the Patients With Atrial Fibrillation.

BACKGROUND

Ischemic strokes (ISs) can appear even in non-gender-related CHADS-VA scores 01 patients with atrial fibrillation (AF). We explored the determinants associated with IS development among the patients with non-gender-related CHADS-VA score 01 AF.

METHODS AND RESULTS

In this single-center retrospective registry data for AF catheter ablation (AFCA), we included 1,353 patients with AF (24.7% female, median age 56 years, and paroxysmal AF 72.6%) who had non-gender-related CHADS-VA score 01, normal left ventricular (LV) systolic function, and available HFPEF score. Among those patients, 113 experienced IS despite a non-gender-related CHADS-VA score of 01. All included patients underwent AFCA, and we evaluated the associated factors with IS in non-gender-related CHADS-VA score 0~1 AF. Patients with ISs in this study had a lower estimated glomerular filtration rate (eGFR) ( < 0.001) and LV ejection fraction (LVEF; = 0.017), larger LA diameter ( < 0.001), reduced LA appendage peak velocity ( < 0.001), and a higher baseline HFPEF score ( = 0.018) relative to those without ISs. Age [odds ratio (OR) 1.11 (1.07-1.17), < 0.001, Model 1] and HFPEF score as continuous [ 1.31 (1.03-1.67), = 0.028, Model 2] variable were independently associated with ISs by multivariate analysis. Moreover, the eGFR was independently associated with IS at low CHADS-VA scores in both Models 1 and 2. AF recurrence was significantly higher in patients with IS (log-rank < 0.001) but not in those with high HFPEF scores (log-rank = 0.079), respectively.

CONCLUSIONS

Among the patients with normal LVEF and non-gender-related CHADS-VA score 0~1 AF, the high HFPEF score, and increasing age were independently associated with IS development (ClinicalTrials.gov Identifier: NCT02138695).