Abstract WP201: Left Atrial Enlargement Predicts 3-Month Outcome in Acute Embolic Stroke

Abstract

Introduction: Although previous studies have shown that the role of left atrial enlargement (LAE) on ischemic stroke, the association with long-term clinical outcome is less clear. We hypothesized that LAE might be associated with long-term outcome in acute ischemic stroke most likely related to embolism (cryptogenic and cardioembolism). Methods: This was a prospective study for patients with acute ischemic stroke as documented by MRI. Echocardiographic LAE was categorized as normal, mild, moderate and severe. Poor outcome was defined as modified Rankin Scale at 3-month of 2-6. The association between LAE and clinical outcome was explored using multivariate analysis adjusting for demographics and other clinical variables. Results: Of 178 patients enrolled, 87 (48.9%) had no LAE, whereas 50 (28.1%) had mild, 30 (16.9%) had moderate and 11 (6.1%) had severe LAE. Infarct volume on MRI was larger in severe LAE (36.53±30.11 cm 3 ) followed by moderate (32.81±28.84 cm 3 ), mild (13.4±16.53 cm 3 ), and normal (11.9±13.16 cm 3 ; p<0.001). At the 3-month follow-up, the poor outcomes were more common in moderate to severe (67%), followed by mild (51%), and normal LAE (46%; p<0.001). In multivariable models adjusted for confounders including heart failure, moderate-to severe LAE compared to normal LAE was associated with poor clinical outcome (odds ratio 1.54, confidence interval 1.04-4.55). Mild LAE was not associated with poor outcome. Conclusions: Our present study shows that LAE is an independent predictor of 3-month clinical outcomes in acute embolic stroke.