Atrial fibrillation in cryptogenic stroke and TIA patients in the nordic atrial fibrillation and stroke The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study : Main results
(2023) In European Stroke Journal 8(1). p.148-156- Abstract
Introduction: Secondary stroke prevention depends on proper identification of the underlying etiology and initiation of optimal treatment after the index event. The aim of the NOR-FIB study was to detect and quantify underlying atrial fibrillation (AF) in patients with cryptogenic stroke (CS) or transient ischaemic attack (TIA) using insertable cardiac monitor (ICM), to optimise secondary prevention, and to test the feasibility of ICM usage for stroke physicians. Patients and methods: Prospective observational international multicenter real-life study of CS and TIA patients monitored for 12 months with ICM (Reveal LINQ) for AF detection. Results: ICM insertion was performed in 91.5% by stroke physicians, within median 9 days after index... (More)
Introduction: Secondary stroke prevention depends on proper identification of the underlying etiology and initiation of optimal treatment after the index event. The aim of the NOR-FIB study was to detect and quantify underlying atrial fibrillation (AF) in patients with cryptogenic stroke (CS) or transient ischaemic attack (TIA) using insertable cardiac monitor (ICM), to optimise secondary prevention, and to test the feasibility of ICM usage for stroke physicians. Patients and methods: Prospective observational international multicenter real-life study of CS and TIA patients monitored for 12 months with ICM (Reveal LINQ) for AF detection. Results: ICM insertion was performed in 91.5% by stroke physicians, within median 9 days after index event. Paroxysmal AF was diagnosed in 74 out of 259 patients (28.6%), detected early after ICM insertion (mean 48 ± 52 days) in 86.5% of patients. AF patients were older (72.6 vs 62.2; p < 0.001), had higher pre-stroke CHA₂DS₂-VASc score (median 3 vs 2; p < 0.001) and admission NIHSS (median 2 vs 1; p = 0.001); and more often hypertension (p = 0.045) and dyslipidaemia (p = 0.005) than non-AF patients. The arrhythmia was recurrent in 91.9% and asymptomatic in 93.2%. At 12-month follow-up anticoagulants usage was 97.3%. Discussion and conclusions: ICM was an effective tool for diagnosing underlying AF, capturing AF in 29% of the CS and TIA patients. AF was asymptomatic in most cases and would mainly have gone undiagnosed without ICM. The insertion and use of ICM was feasible for stroke physicians in stroke units.
(Less)
- author
- author collaboration
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- anticoagulation, arrhythmia monitoring, atrial fibrillation, biomarkers, Cryptogenic stroke, insertable cardiac monitor, secondary prevention
- in
- European Stroke Journal
- volume
- 8
- issue
- 1
- pages
- 9 pages
- publisher
- SAGE Publications
- external identifiers
-
- scopus:85140592455
- pmid:37021182
- ISSN
- 2396-9873
- DOI
- 10.1177/23969873221123122
- language
- English
- LU publication?
- yes
- id
- 0a0f4706-50dc-47e2-9ec4-3191e8eaa808
- date added to LUP
- 2022-11-09 14:41:40
- date last changed
- 2024-06-28 19:02:38
@article{0a0f4706-50dc-47e2-9ec4-3191e8eaa808,
abstract = {{<p>Introduction: Secondary stroke prevention depends on proper identification of the underlying etiology and initiation of optimal treatment after the index event. The aim of the NOR-FIB study was to detect and quantify underlying atrial fibrillation (AF) in patients with cryptogenic stroke (CS) or transient ischaemic attack (TIA) using insertable cardiac monitor (ICM), to optimise secondary prevention, and to test the feasibility of ICM usage for stroke physicians. Patients and methods: Prospective observational international multicenter real-life study of CS and TIA patients monitored for 12 months with ICM (Reveal LINQ) for AF detection. Results: ICM insertion was performed in 91.5% by stroke physicians, within median 9 days after index event. Paroxysmal AF was diagnosed in 74 out of 259 patients (28.6%), detected early after ICM insertion (mean 48 ± 52 days) in 86.5% of patients. AF patients were older (72.6 vs 62.2; p < 0.001), had higher pre-stroke CHA₂DS₂-VASc score (median 3 vs 2; p < 0.001) and admission NIHSS (median 2 vs 1; p = 0.001); and more often hypertension (p = 0.045) and dyslipidaemia (p = 0.005) than non-AF patients. The arrhythmia was recurrent in 91.9% and asymptomatic in 93.2%. At 12-month follow-up anticoagulants usage was 97.3%. Discussion and conclusions: ICM was an effective tool for diagnosing underlying AF, capturing AF in 29% of the CS and TIA patients. AF was asymptomatic in most cases and would mainly have gone undiagnosed without ICM. The insertion and use of ICM was feasible for stroke physicians in stroke units.</p>}},
author = {{Ratajczak-Tretel, B. and Tancin Lambert, A. and Al-Ani, R. and Arntzen, K. and Bakkejord, G. K. and Bekkeseth, H. M.O. and Bjerkeli, V. and Eldøen, G. and Gulsvik, A. and Halvorsen, B. and Høie, G. A. and Ihle-Hansen, H. and Ihle-Hansen, H. and Ingebrigtsen, S. and Johansen, H. and Kremer, C. and Krogseth, S. B. and Kruuse, C. and Kurz, M. and Nakstad, I. and Novotny, V. and Næss, H. and Qazi, R. and Rezaj, M. K. and Rørholt, D. M. and Steffensen, L. H. and Sømark, J. and Tobro, H. and Truelsen, T. C. and Wassvik, L. and Ægidius, K. L. and Atar, D. and Aamodt, A. H.}},
issn = {{2396-9873}},
keywords = {{anticoagulation; arrhythmia monitoring; atrial fibrillation; biomarkers; Cryptogenic stroke; insertable cardiac monitor; secondary prevention}},
language = {{eng}},
number = {{1}},
pages = {{148--156}},
publisher = {{SAGE Publications}},
series = {{European Stroke Journal}},
title = {{Atrial fibrillation in cryptogenic stroke and TIA patients in the nordic atrial fibrillation and stroke The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study : Main results}},
url = {{http://dx.doi.org/10.1177/23969873221123122}},
doi = {{10.1177/23969873221123122}},
volume = {{8}},
year = {{2023}},
}