Predictors of newly diagnosed atrial fibrillation in cryptogenic stroke: a cohort study. Issue 10 (4th November 2012)

• Record Type: Journal Article
• Authors: Bugnicourt, J.‐M.; Flament, M.; Guillaumont, M.‐P.; Chillon, J.‐M.; Leclercq, C.; Canaple, S.; Lamy, C.; Godefroy, O.
• Is Part Of: European journal of neurology. Volume 20:Issue 10(2013:Oct.)
• Page Start: 1352
• Page End: 1359
• Publication Date: 2012-11-04
• Subjects: Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.12017
• Languages: English
• ISSNs: 1351-5101

Abstract

<abstract abstract-type="main" id="ene12017-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ene12017-sec-0001" sec-type="section"> <title>Background and purpose</title> <p>A significant proportion of cryptogenic ischaemic strokes are due to paroxysmal atrial fibrillation (AF). As paroxysmal AF appears to inexorably progress to persistent or permanent AF, this study with long‐term follow‐up was designed to establish the profile of patients who developed AF after hospital discharge.</p> </sec> <sec id="ene12017-sec-0002" sec-type="section"> <title>Methods</title> <p>All patients with cryptogenic ischaemic stroke over a 1‐year period were included (<italic>n</italic> = 164). Patients were prospectively followed up at the outpatient clinic. Information on long‐term outcome included the presence of newly diagnosed AF (NDAF). A specific NDAF assessment was performed at least 2 years after the index stroke using a structured telephone interview. Baseline clinical, laboratory, and echocardiographic data of these patients were retrospectively recorded. Independent predictive factors were then used to produce a predictive grading score for NDAF, derived by logistic regression analysis.</p> </sec> <sec id="ene12017-sec-0003" sec-type="section"> <title>Results</title> <p>With a median follow‐up of 854 days, 22 cases of NDAF (13%) were observed. On multivariate analysis, factors associated with NDAF were age ≥72 years (two points), history of coronary artery disease (one point) or stroke (one point), and left atrial area ≥16 cm<sup>2</sup> (two points) (total score ranging from 0 to 6). Patients with a score ≤1 point did not have NDAF during follow‐up.</p> </sec> <sec id="ene12017-sec-0004" sec-type="section"> <title>Conclusions</title> <p>In cryptogenic ischaemic stroke, the NDAF score can be used to target patients at high risk of developing AF after hospital discharge, as a score of 0–1 was highly predictive of the absence of NDAF during follow‐up. These results need to be confirmed in prospective studies.</p> </sec> </abstract>