Correlation of paroxysmal supraventricular tachycardia, atrial fibrillation, and sinus rhythm with incidences of new thromboembolic stroke in 1476 old-old patients.
The relationship between supraventricular tachycardia and the incidence of thromboembolic stroke has not been previously reported. We investigated in a prospective study the incidence of new thromboembolic stroke in 1476 patients, mean age 81 years, with atrial fibrillation, paroxysmal supraventricular tachycardia, or sinus rhythm detected by 24-hour ambulatory electrocardiograms. New thromboembolic stroke developed at 31-month follow-up in 87 of 201 patients (43%) with atrial fibrillation, at 43-month follow-up in 84 of 493 patients (17%) with paroxysmal supraventricular tachycardia, and at 45-month follow-up in 143 of 782 patients (18%) with sinus rhythm (p < 0.0001 comparing atrial fibrillation with paroxysmal supraventricular tachycardia or sinus rhythm). Kaplan-Meier survival curves showed a higher significance of thromboembolic stroke in patients with atrial fibrillation, compared to patients with paroxysmal supraventricular tachycardia or sinus rhythm (log-rank: p < 0.0001). Multivariate Cox regression model showed that independent significant predictors of thromboembolic stroke were: a) atrial fibrillation (relative risk = 3.31); b) prior thromboembolic stroke (relative risk = 2.85); c) sex (relative risk for women = 0.75); and d) age (relative risk = 1.02). These data show that atrial fibrillation is an independent predictor of thromboembolic stroke in elderly patients, and that paroxysmal supraventricular tachycardia is not associated with thromboembolic stroke.
Aronow
W S
WS
Hebrew Hospital Home, New York City, New York, USA.
Ahn
C
C
Mercando
A D
AD
Epstein
S
S
Gutstein
H
H
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications*; D002561:Cerebrovascular Disorders / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D013617:Tachycardia, Supraventricular / Q000150:complications*; D013923:Thromboembolism / Q000453:epidemiology*