Stroke Literature Synopses: Clinical Science

Despite thorough diagnostic evaluations to determine stroke cause, ≈1 in 3 strokes remain cryptogenic. Atrial fibrillation (AF) has long been established as a risk factor for stroke; however, recent evidence suggests that other atrial derangements may also play a role. In this study, Kamel et al conducted a longitudinal, population-based study of participants aged 45 to 64 years without clinically apparent AF at baseline (n=14 542) enrolled in the Atherosclerosis Risk in Communities Study in 1987 to 1989, and followed up every 3 years thereafter, to evaluate whether ECGdefined atrial abnormality (abnormally increased P-wave terminal force in lead V 1 [PTFV 1 ] >4000 uV x ms) was associated with increased risk of nonlacunar stroke. They found that atrial abnormality was an independent risk factor for nonlacunar strokes, suggesting that it is a cardioembolic source.