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Is paroxysmal supraventricular tachycardia truly benign? Insightful association between PSVT and stroke from a National Inpatient Database Study

  • Sharan Prakash Sharma
  • Ashok Kondur
  • Rakesh Gopinathannair
  • Timothy Kamerzell
  • Moussa Mansour
  • Srijoy Mahapatra
  • Krzysztof Bartus
  • Dhanunjaya LakkireddyEmail author
MULTIMEDIA REPORT

Abstract

Background

Atrial fibrillation and flutter are well-known causes of stroke. Whether other atrial arrhythmias categorized as paroxysmal supraventricular tachycardia (PSVT) are associated with stroke is less clear. We aimed to evaluate the association of PSVT with ischemic and embolic stroke and its impact on short-term outcomes in hospitalized stroke patients.

Methods

National Inpatient Sample database of the USA was used to assess the association of PSVT with ischemic stroke. Atrial fibrillation and flutter were excluded to minimize the confounding effects. The association of PSVT with stroke was evaluated using univariate and multivariate analysis. Subgroup analyses by gender, age, and stroke type were also performed.

Results

PSVT was associated with increased odds of overall ischemic stroke in univariate [OR 1.18 (95% CI 1.09–1.27) p < 0.001] analysis. No such association was observed in multivariate analysis (OR 1.06 (95% CI 0.98–1.14) p = 0.1) or with subgroup analysis by gender and age. However, PSVT was associated with embolic stroke in both univariate (OR 2.01 (95%CI 1.67–2.43, p < 0.001) and multivariate analysis (OR 1.7 (95%CI 1.4–2.14) p < 0.001) as well as in subgroup analyses by gender and age. Furthermore, the presence of PSVT was associated with increased mortality in embolic stroke (OR 4.11, CI 2.29 to 7.39, p < 0.001) and increased total hospital cost and length of hospital stay in all stroke types.

Conclusions

PSVT is independently associated with higher prevalence of embolic stroke but not with overall ischemic stroke. Patients with embolic stroke in the presence of PSVT have worse in-hospital outcomes with increased mortality.

Keywords

Paroxysmal supraventricular tachycardia Ischemic stroke Embolic stroke National Inpatient database 

Abbreviations

PSVT

Paroxysmal supraventricular tachycardia

AF

Atrial fibrillation

AFl

Atrial flutter

CI

Confidence interval

OR

Odds ratio

NIS

National Inpatient Sample

ICD

International Classification of Disease

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10840_2019_651_MOESM1_ESM.docx (13 kb)
ESM 1 Supplementary Appendix: ICD-9 codes used for identification of study population (DOCX 12 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Sharan Prakash Sharma
    • 1
  • Ashok Kondur
    • 1
  • Rakesh Gopinathannair
    • 2
  • Timothy Kamerzell
    • 3
  • Moussa Mansour
    • 4
  • Srijoy Mahapatra
    • 5
  • Krzysztof Bartus
    • 6
  • Dhanunjaya Lakkireddy
    • 2
    Email author
  1. 1.Division of Cardiovascular MedicineGarden City HospitalGarden CityUSA
  2. 2.The Kansas City Heart Rhythm InstituteHCA MidWest HealthOverland ParkUSA
  3. 3.Quivira Internal MedicineOverland Park Regional Medical CenterOverland ParkUSA
  4. 4.Section of ElectrophysiologyMassachusetts General HospitalBostonUSA
  5. 5.Abbott LaboratoriesMinneapolisUSA
  6. 6.Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical CollegeJohn Paul II HospitalKrakowPoland

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