Ischaemic stroke in myotonic dystrophy type 1 patients may up the risk of Afib

Takeaway

• In patients with myotonic dystrophy type 1, ischaemic stroke was found to be associated with Afib.
• Congestive heart failure, hypertension, age, diabetes and prior stroke (CHADS2) score could be useful in managing patients with myotonic dystrophy type 1.

Why this matters

• Only a few studies have assessed the risk for cerebral infarction in patients with myotonic dystrophy type 1.
• No studies have evaluated the risk for cerebral infarction using CT or MRI.

Study design

• Retrospective study of 108 patients with myotonic dystrophy type 1.
• Patients’ medical history, neuroradiological imaging, ECGs, and treatment were reviewed.
• Funding: None.

Key results

• Overall, several risk factors were seen in patients undergoing MRI (n=71), including hyperlipidaemia (n=20), diabetes mellitus (n=18), atrial flutter (n=2), Afib (n=3) and atrioventricular block (n=38).
• On the CHADS2 score, 11 patients scored more than 2; on CHA2DS2-visual analogue scale c (VASc), 22 patients scored more than 2.
• Overall, ischaemic strokes were seen in 9 patients with 1 patient having atrial flutter and 4 having Afib, and their CHADS2 and CHA2DS2-VASc scores were higher than 2.
• Both groups showed a significant difference in Afib (P<.001), antiarrhythmic drug use (P<.001), CHADS2 (P<.001) and CHA2DS2-VASc (P<.001) scores.

Limitations

• Retrospective study design.