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The relationship between atrial myopathy with and without atrial fibrillation to cryptogenic stroke

Heart Science Journal · Vol. 6 No. 2 (2025)

DOI
10.21776/ub.hsj.2025.006.02.9
ISSN
2721-9984, 2721-9976
Terbit
2025-04-30
Penerbit
Universitas Brawijaya
Bahasa
en
Lisensi
creativecommons.org/licenses/by/4.0

Abstrak

Background: Ischemic stroke is the second most common cause of mortality globally, with some cases classified as cryptogenic strokes (CS) where the cause is unknown. Traditionally, atrial fibrillation (AF) has been considered the primary cause of ischemic stroke, but recent clinical trials and the occurrence of CS have led to the concept of atrial myopathy (AM). AM not only serves as a substrate for AF, promoting thrombus formation, but also causes blood stasis in the atrium, resulting in stroke without AF. Objective: The relationship between AM with and without AF to CS incidences at Saiful Anwar Hospital, Malang was evaluated in this study. Methods: Retrospectively analyzed medical records of patients from January 2023 to December 2024. Univariate analysis for baseline characteristic, bivariate analysis with Chi square, t-test and Mann Whitney u-test and multivariate analysis for predictive model using logistic regression were used for determine the relationship among variable in this study. Result: 112 patients were included in this study. AM has a statistically significant (OR 31.762, 95% CI: 3.965-254.427, p=0.001) as a predictor of CS, but AF did not (OR: 1.666, 95% CI: 0.414-6.707, p=0.473). A better predictive value was achieved with CHA2DS2-VASC ≥2 combined with AM (OR 7.948, 95% CI: 2.628-24.034, p<0.001), compared with CHA2DS2-VASC ≥2 alone (OR 1.909, 95% CI: 0.651-5.598, p=0.239) or CHA2DS2-VASC ≥2 combined with AF and AM (OR 3.600, 95% CI: 0.985-13.159, p=0.050). Conclusion: Atrial myopathy with and without atrial fibrillation had association to increasing the risk of cryptogenic stroke. Combining AM with the CHA2DS2-VASC score can improve stroke cryptogenic risk prediction

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Rekan penulisOrganisasiArtikel bersama
Anna Fuji RahimahUniversity of Brawijaya30
Indra PrasetyaUniversity of Brawijaya26
Setyasih AnjarwaniUniversity of Brawijaya25
Cholid Tri TjahjonoUniversity of Brawijaya22
Novi KurnianingsihUniversity of Brawijaya22
Budi SatrijoUniversity of Brawijaya20
Sasmojo WiditoUniversity of Brawijaya18
Heny MartiniUniversity of Brawijaya16
Djanggan SargowoUniversity of Brawijaya13
Yoga WaranugrahaUniversity of Brawijaya12
Adhika Prastya WikanandaUniversity of Brawijaya8
Wella KarolinaUniversity of Brawijaya7
Tri AstiawatiUniversity of Brawijaya6
Putri Annisa KamilaUniversity of Brawijaya4
Fandy HazzyUniversity of Brawijaya4
Icmi Dian RochmawatiUniversity of Brawijaya4
Olivia HandayaniUniversity of Brawijaya4
Fahmy RusnantaUniversity of Brawijaya4
Fitranti Suciati LaitupaUniversity of Brawijaya4
Valerinna YogibuanaAfiliasi tidak diketahui4
Nikhen NoverikeUniversity of Brawijaya4
Dadang HendrawanUniversity of Brawijaya3
Muhammad Rizki FadlanUniversity of Brawijaya3
Hayla Iqda MillisaniUniversity of Brawijaya3
Oktivani Adelathifa RahmaUniversity of Brawijaya3
Puspa LestariUniversity of Brawijaya3
Tonny AdriyantoUniversity of Brawijaya3
Jonny Karunia FajarUniversity of Brawijaya3
Anita Surya SantosoAfiliasi tidak diketahui3
Anna Fuji RahimahAfiliasi tidak diketahui3
Seprian WidasmaraUniversity of Brawijaya3
Mokhamad Aswin BaharUniversity of Brawijaya3
Veny KurniawatiUniversity of Brawijaya2
Oktafin Srywati PamunaUniversity of Brawijaya2
Taufieq Ridlo MakhmudUniversity of Brawijaya2
Faris Wahyu NugrohoUniversity of Brawijaya2
Dea Arie KurniawanUniversity of Brawijaya2

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Sumber metadata: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">The relationship between atrial myopathy with and without atrial fibrillation to cryptogenic stroke</dc:title>
	<dc:creator xml:lang="en">Kahadi, Cik</dc:creator>
	<dc:creator xml:lang="en">Rizal , Ardian</dc:creator>
	<dc:creator xml:lang="en">Rohman, Mohammad Saifur</dc:creator>
	<dc:subject xml:lang="en">Cryptogenic Stroke </dc:subject>
	<dc:subject xml:lang="en">Atrial Myopathy</dc:subject>
	<dc:subject xml:lang="en">Atrial Fibrillation</dc:subject>
	<dc:subject xml:lang="en">CHA2DS2-VASC score</dc:subject>
	<dc:description xml:lang="en">Background: Ischemic stroke is the second most common cause of mortality globally, with some cases classified as cryptogenic strokes (CS) where the cause is unknown. Traditionally, atrial fibrillation (AF) has been considered the primary cause of ischemic stroke, but recent clinical trials and the occurrence of CS have led to the concept of atrial myopathy (AM). AM not only serves as a substrate for AF, promoting thrombus formation, but also causes blood stasis in the atrium, resulting in stroke without AF.
Objective: The relationship between AM with and without AF to CS incidences at Saiful Anwar Hospital, Malang was evaluated in this study.
Methods: Retrospectively analyzed medical records of patients from January 2023 to December 2024. Univariate analysis for baseline characteristic, bivariate analysis with Chi square, t-test and Mann Whitney u-test and multivariate analysis for predictive model using logistic regression were used for determine the relationship among variable in this study.
Result: 112 patients were included in this study. AM has a statistically significant (OR 31.762, 95% CI: 3.965-254.427, p=0.001) as a predictor of CS, but AF did not (OR: 1.666, 95% CI: 0.414-6.707, p=0.473). A better predictive value was achieved with CHA2DS2-VASC ≥2 combined with AM (OR 7.948, 95% CI: 2.628-24.034, p&amp;lt;0.001), compared with CHA2DS2-VASC ≥2 alone (OR 1.909, 95% CI: 0.651-5.598, p=0.239) or CHA2DS2-VASC ≥2 combined with AF and AM (OR 3.600, 95% CI: 0.985-13.159, p=0.050).
Conclusion: Atrial myopathy with and without atrial fibrillation had association to increasing the risk of cryptogenic stroke. Combining AM with the CHA2DS2-VASC score can improve stroke cryptogenic risk prediction</dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2025-04-30</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/20331</dc:identifier>
	<dc:identifier>10.21776/ub.hsj.2025.006.02.9</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2025.006.02</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/20331/492</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2025 Cik Kahadi, dr. Ardian Rizal, SpJP(K), Prof. dr. Mohammad Saifur Rohman, SpJP(K), Ph.D.</dc:rights>
	<dc:rights xml:lang="en">http://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>