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Junctional bradycardia is a potential risk factor of stroke
- Title
- Junctional bradycardia is a potential risk factor of stroke
- Authors
- Kim, Gwang Sil; Uhm, Jae-Sun; Kim, Tae-Hoon; Lee, Hancheol; Park, Junbeom; Park, Jin-Kyu; Joung, Boyoung; Pak, Hui-Nam; Lee, Moon-Hyoung
- Ewha Authors
- 박준범
- SCOPUS Author ID
- 박준범
- Issue Date
- 2016
- Journal Title
- BMC NEUROLOGY
- ISSN
- 1471-2377
- Citation
- BMC NEUROLOGY vol. 16
- Keywords
- Junctional bradycardia; Thromboembolic events; Stroke
- Publisher
- BIOMED CENTRAL LTD
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background: This study aimed to determine the risk of thromboembolic events in patients with junctional bradycardia(JB). Methods: We retrospectively reviewed electrocardiograms(ECGs) for 380,682 patients. Those with JB on an ECG at least twice over a >= 3-month interval were included for analysis. We additionally included 138 CHADS(2) score-matched patients(age, 68.4 +/- 15.7 years; male, 52.2 %) in sinus rhythm as a control group. Between the JB patients(with or without retrograde P wave) and controls, we compared incidences of ischemic stroke and a composite of ischemic stroke, renal infarction, ischemic colitis, acute limb ischemia, and pulmonary embolism. Results: Among 380,682 patients (age, 47.6 +/- 19.9 years; male, 49.3 %), 69 patients (age, 68.5 +/- 16.5 years; male, 50.7 %) exhibited JB on an ECG at least twice over a >= 3-month interval; the overall prevalence of JB was 0.02 %. The mean follow-up period was 27.2 +/- 26.2 months. Forty-five patients (65.2 %) in the JB group had no retrograde P wave. Ischemic stroke incidence was significantly higher in JB patients without a retrograde P wave than in controls (6/45 patients [13.3 %] and 3/138 patients [2.2 %], respectively; P = 0.007). The incidence of composite thromboembolic events was also significantly higher in JB patients without a retrograde P wave than in controls (8/45 patients [17.8 %] and 4/138 patients [2.9 %], respectively; P = 0.011). In a Cox proportional hazards model, JB patients without a P wave showed a greater incidence of stroke (hazard ratio, 8.89 [2.20-33.01], P = 0.007) than controls and JB patients with a P wave. Conclusions: Junctional bradycardia is potentially associated with ischemic stroke, particularly in the absence of an identifiable retrograde P wave.
- DOI
- 10.1186/s12883-016-0645-9
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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