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Atrial Pathophysiology Differs in Black, White Stroke Patients

WEDNESDAY, Dec. 2, 2020 -- Differences in left atrial structure and pathophysiology are found between Black and White patients with ischemic stroke, according to a study published online Nov. 25 in Neurology.

Hooman Kamel, M.D., from Weill Cornell Medicine in New York City, and colleagues compared atrial cardiopathy phenotypes between Black and White ischemic stroke patients. Markers of atrial cardiopathy were assessed in the Greater Cincinnati/Northern Kentucky Stroke study. Electrocardiograms (ECGs) and reports of echocardiograms performed during stroke evaluation in the 2010/2015 study periods were obtained.

The researchers found that 2,391 of the 3,426 ischemic stroke cases in Black and White patients without atrial fibrillation or flutter had a left atrial diameter measurement. In unadjusted and adjusted models, Black race was associated with a smaller left atrial diameter (ß coefficient [95 percent confidence interval], −0.11 [−0.17 to −0.05] and −0.15 [−0.21 to −0.09], respectively). In 3,209 patients, P-wave terminal force in ECG lead V1 (PTFV1) measurements were available. In unadjusted and adjusted models, Black race was associated with greater PTFV1 (ß coefficient [95 percent confidence interval], 1.59 [1.21 to 1.97] and 1.45 [1.00 to 1.80], respectively).

"Our findings should not be taken to imply that these racial differences in people with stroke reflect innate biological differences," Kamel said in a statement. "Our findings suggest that the current standards for diagnosing left atrial disease that can lead to stroke may need to be updated. These standards were established in groups of exclusively White people and may not fully reflect the variety and complexity of how these acquired cardiac issues are manifested in all people."

Several authors disclosed financial ties to the pharmaceutical industry.

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Posted: December 2020

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