Echocardiography
Beyond Atrial Fibrillation: Clinical and Echocardiographic Predictors of Ischaemic Stroke and Systemic Thromboembolism in Rheumatic Heart Disease: A Systematic Review and Meta-Analysis
By Baby N, Gowda N and Neha HV.
Abstract
Purpose
Atrial fibrillation (AF) is the best-established thromboembolic risk factor in rheumatic heart disease (RHD), but stroke and thromboembolism also occur without documented AF. We systematically synthesised associations between non-AF clinical/echocardiographic predictors and thromboembolism in RHD, comparing AF-adjusted with unadjusted estimates.
Methods
PubMed/MEDLINE, Embase, Scopus, and Web of Science were searched, supplemented by Google Scholar and citation screening. Eligible studies evaluated RHD patients with ≥1 non-AF predictor of stroke or thromboembolism. Two reviewers performed selection, extraction, and QUIPS risk-of-bias assessment; certainty was graded using GRADE. Unadjusted, adjusted, and AF-adjusted estimates were extracted separately, and random-effects meta-analysis was performed when feasible.