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Predictors of Thromboembolism in Atrial Fib:II. Echocard Features of Pts at Risk The Stroke Prevention in A Fib Investigators, Ann Int Med 116:6-121992., , 1992 See this aricle in Pubmed Article Abstract Left ventricular dysfunction from 2-D echocardiograms(P=0.003)and the size of the left atrium from M-mode echocardiograms(P=0.02)were the strongest independent predictors of later thromboembolism.Multivariate analysis of these two independent echocardiographic predictors with the three independent clinical predictors of thromboembolism(history of hypertension,recent congestive heart failure,previous thromboembolism) identified 26%of the cohort with a low risk for thromboembolism(1.0%per year;95%CI,0.2%to 4.0%).Compared with risk stratification using clinical variables alone,echocardiographic results altered thromboembolic risk stratification in 18%of the entire cohort and in 38%of those without clinical risk factors.Both left ventricular and left atrial variables are significant predictors of thromboembolism in patients with nonvalvular atrial fibrillation.Our results challenge traditional views of the pathogenesis of ischemic stroke in patients with atrial fibrillation and suggest that standard echocardiography contributes to risk stratification, differentiating the one third of patients without clinical risk factors who are at increased risk for stroke from the remainder who may not need antithrombotic prophylaxis.

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(click to filter results - removes previous filter) atrial fibrillation cerebral embolism cerebral embolism,cardiac origin cerebrovascular accident cerebrovascular disease,risk factors in echocardiogram embolism treatment of neurologic disorder

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