Navigation Links
Researchers identify stroke predictors in black patients
Date:4/28/2009

WINSTON-SALEM, N.C. Predictors of atrial fibrillation (AF or afib) might offer physicians a better way to prevent stroke in blacks, according to a new study done by researchers at Wake Forest University School of Medicine.

AF is an irregular and often rapid heart rate that commonly causes poor blood flow to the body, as well as symptoms of heart palpitations, shortness of breath and weakness. Despite low reported prevalence of AF one of the major risk factors for stroke in black patients, they suffer strokes five times more often than white patients and die from them two times more often.

That paradox might result from limitations in the methods (electrocardiograms (ECG) or self-report) used to detect AF, said Elsayed Z. Soliman, M.D., M.Sc. M.S., associate director of the Epidemiological Cardiology Research Center (EPICARE) at the School of Medicine and lead author of the study.

"The limitations stem from the fact that AF is intermittent in at least 30 percent of patients, and most patients are not aware if they have AF or not," Soliman said. "Trying to detect AF using an ECG, or simply counting on patients to know if they have it, leads to under-diagnosis of the condition most of the time. Our research suggests that being proactive in predicting it may be a better approach."

The study appears in the current issue of Stroke, the peer-reviewed journal of the American Heart Association and American Stroke Association.

An electrocardiogram is a diagnostic tool that measures and records the electrical activity of the heart. Interpretation of an ECG report allows diagnosis of a wide range of heart conditions from minor to life threatening.

Doctors use ECGs to diagnose AF, and therefore assess the risk of stroke in different patients. However, ECG reports of AF have not been as useful for identifying black patients at high risk. While black patients suffer more ischemic strokes than white patients, their ECG results do not indicate AF as often.

For the study, researchers reviewed ECG data from the Atherosclerosis Risk in Communities (ARIC) study supported by the National Heart, Lung and Blood Institute. More than 15,000 people in North Carolina, Mississippi, Minnesota and Maryland participated in the study during the 1980s and 90s.

Researchers found that, while ECG reports of AF were significantly less in black participants than in whites, black participants ultimately suffered more ischemic strokes. However, the analysis uncovered that ECGs on black participants revealed a higher rate of predictors of future AF than did the ECGs of the white participants. These ECG predictors of AF (P-wave terminal force, P-wave duration, P-wave area and PR duration) represent electrical activity within the upper two chambers of heart, or atria, which are the sources of blood clots that cause stroke if AF occurs. These ECG predictors of AF were strongly predictive of strokes and AF in blacks and whites, so researchers believe their existence could be considered as presence or future presence of AF.

"With the blacks having more abnormal ECG predictors of AF, as the results showed, there is a possibility that blacks might actually have a higher prevalence of AF than previous studies have picked up on," Soliman said. "Blacks may have more "intermittent" AF, the difficult type of AF to detect, which could be the reason why previous studies underestimated AF diagnosis more in blacks."

Soliman added that physicians, knowing this, should use the ECG to evaluate black patients' risk of stroke by determining if the patient has certain predictors of AF, instead of the condition itself. If so, the patients may be able to be treated with blood thinners as if they have AF. It is a treatment adjustment that could help prevent stroke, however further investigation into the subject is needed, he said.

"P-wave terminal force in the ECG may provide a strong independent predictor for incidence stroke and AF in clinical practice," Soliman said.

"For the physician evaluating black patients for the risk of stroke, these results show that you cannot think AF is less common in this population," Soliman said.

Soliman said that the next step in research on this subject is to do a long-term ECG study to confirm the hypothesis that AF, especially intermittent AF, has been under-diagnosed in blacks.

"We need further studies using long-term ECG recording 48 hours to 72 hours or event monitors to detect AF" he said. "The cost of these tests on population studies has always been an obstacle. However, with the results of this study, it may be worth it."


'/>"/>

Contact: Jessica Guenzel
jguenzel@wfubmc.edu
336-716-3487
Wake Forest University Baptist Medical Center
Source:Eurekalert

Related medicine news :

1. Penn Medicine, CHOP researchers demonstrate first common genetic risk factors for autism
2. Four legendary LA BioMed physician-researchers honored
3. Researchers find drug that inhibits acute leukemia cell growth
4. Researchers find medical inpatients with unhealthy alcohol use may benefit from brief intervention
5. Karmanos Cancer Institute Researchers Provide New Hope for Breast Cancer Treatment
6. The Traveling Nut: Researchers From Around the World Explore the Impact of Almonds on the Body
7. Brigham and Women's Hospital Researchers Demonstrate a More Direct Delivery of Cancer Drugs to Tumors
8. Mayo Clinic-led researchers confirm gene variants associated with the most common adult leukemia
9. Mayo Clinic researchers formulate treatment combination lethal to pancreatic cancer cells
10. USC researchers develop new drug to target tumor cells and blood vessels
11. Pitt receives $2.8 million to train HIV/AIDS researchers in Mozambique, Brazil and India
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... ... June 24, 2016 , ... ... Scientific Sessions in Dallas that it will receive two significant new grants to ... came as PHA marked its 25th anniversary by recognizing patients, medical professionals and ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... ... now offering micro-osteoperforation for accelerated orthodontic treatment. Dr. Cheng has extensive experience with ... Damon brackets , AcceleDent, and accelerated osteogenic orthodontics. , Micro-osteoperforation is a ...
(Date:6/24/2016)... ... 2016 , ... Topical BioMedics, Inc, makers of Topricin and MyPainAway Pain Relief Products, join The ... raise to $12 an hour by 2020 and then adjusting it yearly to increase at ... the minimum wage, assure the wage floor does not erode again, and make future increases ...
(Date:6/24/2016)... ... June 24, 2016 , ... EB Medicine presented its first-ever ... Medicine conference in Ponte Vedra Beach, FL. The awards honor the outstanding work ... Practice and Pediatric Emergency Medicine Practice. , “With this award, we recognize ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... The Grove Investment Group (TGIG), has initiated cultivation and processing operations at its ... Vegas and Pahrump, Nevada. , Puradigm is the manufacturer of a complete system ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... 2016 The Academy of Managed Care Pharmacy ... that would allow biopharmaceutical companies to more easily share ... formulary and coverage decisions, a move that addresses the ... The recommendations address restrictions in the sharing ... drug label, a prohibition that hinders decision makers from ...
(Date:6/24/2016)... , June 24, 2016 ... Market by Type (Standard Pen Needles, Safety Pen Needles), ... (Insulin, GLP-1, Growth Hormone), Mode of Purchase (Retail, Non-Retail) ... MarketsandMarkets, This report studies the market for the forecast ... to reach USD 2.81 Billion by 2021 from USD ...
(Date:6/23/2016)... 2016  MedSource announced today that it has ... solution of choice.  This latest decision demonstrates MedSource,s ... their clients by offering a state-of-the-art electronic data ... nowEDC as the EDC platform of choice in ... "nowEDC has long been a preferred EDC platform ...
Breaking Medicine Technology: