Frontiers in Neurology (Feb 2020)

Left Atrial Enlargement and the Risk of Stroke: A Meta-Analysis of Prospective Cohort Studies

  • Yicheng Xu,
  • Liming Zhao,
  • Lvming Zhang,
  • Yalei Han,
  • Peifu Wang,
  • Shengyuan Yu

DOI
https://doi.org/10.3389/fneur.2020.00026
Journal volume & issue
Vol. 11

Abstract

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Background: The association between left atrial size and the risk of stroke has not been fully understood. We performed a meta-analysis of prospective cohort studies to determine whether left atrial enlargement (LAE) is associated with an increased risk of stroke.Methods: We searched PubMed, EMBASE, Web of Science, and the Cochrane Library through May 2019. Prospective cohort studies were included if they reported hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of stroke with respect to LAE. All meta-analyses were performed using a random-effects model.Results: Six studies involving 66,007 participants and 3,549 stroke events were included. Compared with patients without LAE, those with LAE had an increased risk of stroke (adjusted HR 1.68, 95% CI 1.36–2.07). There was also a graded association with stroke relating to LAE (adjusted HR for mild LAE 1.50, 95% CI 0.98–2.28; moderate LAE 1.40, 95% CI 1.12–1.75; and severe LAE 1.59, 95% CI 1.33–1.90). Furthermore, for each increase of 1 cm in left atrial diameter, the odds of stroke were increased by 24% (adjusted HR 1.24, 95% CI 1.03–1.50).Conclusions: Our meta-analysis demonstrated that LAE is associated with an increased and graded risk of stroke.

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