In:
PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 7 ( 2023-7-20), p. e0287318-
Abstract:
Implantable cardiac monitors (ICM) can facilitate the detection of asymptomatic atrial fibrillation episodes. We performed a systematic review and meta-analysis to investigate whether ICM can prevent stroke in patients with prior stroke and risk factors for stroke. Methods This study included randomized controlled trials comparing ICM with conventional (non-ICM) external cardiac monitoring in patients with prior stroke and risk factors for stroke. We searched Medline, Embase, and CENTRAL from inception until January 5, 2022, without language restriction. Quantitative pooling of the data was undertaken using a random-effects model. The primary outcome was ischemic stroke at the longest follow-up. Results Four trials comprising 7237 patients were included. ICM was significantly associated with decreased risk of ischemic stroke (RR 0.76; 95% CI, 0.59–0.97; moderate-quality evidence) in patients with prior stroke and risk factors for stroke. ICM was associated with higher detection of atrial fibrillation (RR 4.21, 95% CI 2.26–7.85) and use of oral anticoagulants (RR 2.29, 95% CI 2.07–2.55). Conclusions ICM results in a significantly lower risk of ischemic stroke than conventional (non-ICM) external cardiac monitoring in patients with prior stroke and risk factors for stroke. Due to the clinical heterogeneity of study population and limited related studies, more trials were needed to furtherly explore the topic in patients with prior stroke or high risk of stroke.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0287318
DOI:
10.1371/journal.pone.0287318.g001
DOI:
10.1371/journal.pone.0287318.g002
DOI:
10.1371/journal.pone.0287318.g003
DOI:
10.1371/journal.pone.0287318.t001
DOI:
10.1371/journal.pone.0287318.t002
DOI:
10.1371/journal.pone.0287318.s001
DOI:
10.1371/journal.pone.0287318.s002
DOI:
10.1371/journal.pone.0287318.s003
DOI:
10.1371/journal.pone.0287318.s004
DOI:
10.1371/journal.pone.0287318.s005
DOI:
10.1371/journal.pone.0287318.s006
DOI:
10.1371/journal.pone.0287318.s007
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2267670-3
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