Prediction of underlying atrial fibrillation in patients with a cryptogenic stroke : results from the NOR-FIB Study
(2023) In Journal of Neurology 270(8). p.4049-4059- Abstract
BACKGROUND: Atrial fibrillation (AF) detection and treatment are key elements to reduce recurrence risk in cryptogenic stroke (CS) with underlying arrhythmia. The purpose of the present study was to assess the predictors of AF in CS and the utility of existing AF-predicting scores in The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study.
METHOD: The NOR-FIB study was an international prospective observational multicenter study designed to detect and quantify AF in CS and cryptogenic transient ischaemic attack (TIA) patients monitored by the insertable cardiac monitor (ICM), and to identify AF-predicting biomarkers. The utility of the following AF-predicting scores was tested: AS5F, Brown ESUS-AF, CHA
2DS
2-VASc,... (More)BACKGROUND: Atrial fibrillation (AF) detection and treatment are key elements to reduce recurrence risk in cryptogenic stroke (CS) with underlying arrhythmia. The purpose of the present study was to assess the predictors of AF in CS and the utility of existing AF-predicting scores in The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study.
METHOD: The NOR-FIB study was an international prospective observational multicenter study designed to detect and quantify AF in CS and cryptogenic transient ischaemic attack (TIA) patients monitored by the insertable cardiac monitor (ICM), and to identify AF-predicting biomarkers. The utility of the following AF-predicting scores was tested: AS5F, Brown ESUS-AF, CHA
2DS
2-VASc, CHASE-LESS, HATCH, HAVOC, STAF and SURF.
RESULTS: In univariate analyses increasing age, hypertension, left ventricle hypertrophy, dyslipidaemia, antiarrhythmic drugs usage, valvular heart disease, and neuroimaging findings of stroke due to intracranial vessel occlusions and previous ischemic lesions were associated with a higher likelihood of detected AF. In multivariate analysis, age was the only independent predictor of AF. All the AF-predicting scores showed significantly higher score levels for AF than non-AF patients. The STAF and the SURF scores provided the highest sensitivity and negative predictive values, while the AS5F and SURF reached an area under the receiver operating curve (AUC) > 0.7.
CONCLUSION: Clinical risk scores may guide a personalized evaluation approach in CS patients. Increasing awareness of the usage of available AF-predicting scores may optimize the arrhythmia detection pathway in stroke units.
(Less)
- author
- author collaboration
- organization
- publishing date
- 2023-05-10
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Neurology
- volume
- 270
- issue
- 8
- pages
- 4049 - 4059
- publisher
- Springer
- external identifiers
-
- scopus:85159044657
- pmid:37162578
- ISSN
- 1432-1459
- DOI
- 10.1007/s00415-023-11680-8
- language
- English
- LU publication?
- yes
- additional info
- © 2023. The Author(s).
- id
- 19f98e71-d834-43aa-b09b-60c970ecdbe3
- date added to LUP
- 2023-05-15 18:27:52
- date last changed
- 2024-06-29 04:07:23
@article{19f98e71-d834-43aa-b09b-60c970ecdbe3,
abstract = {{<p>BACKGROUND: Atrial fibrillation (AF) detection and treatment are key elements to reduce recurrence risk in cryptogenic stroke (CS) with underlying arrhythmia. The purpose of the present study was to assess the predictors of AF in CS and the utility of existing AF-predicting scores in The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study.</p><p>METHOD: The NOR-FIB study was an international prospective observational multicenter study designed to detect and quantify AF in CS and cryptogenic transient ischaemic attack (TIA) patients monitored by the insertable cardiac monitor (ICM), and to identify AF-predicting biomarkers. The utility of the following AF-predicting scores was tested: AS5F, Brown ESUS-AF, CHA<br>
2DS<br>
2-VASc, CHASE-LESS, HATCH, HAVOC, STAF and SURF.<br>
</p><p>RESULTS: In univariate analyses increasing age, hypertension, left ventricle hypertrophy, dyslipidaemia, antiarrhythmic drugs usage, valvular heart disease, and neuroimaging findings of stroke due to intracranial vessel occlusions and previous ischemic lesions were associated with a higher likelihood of detected AF. In multivariate analysis, age was the only independent predictor of AF. All the AF-predicting scores showed significantly higher score levels for AF than non-AF patients. The STAF and the SURF scores provided the highest sensitivity and negative predictive values, while the AS5F and SURF reached an area under the receiver operating curve (AUC) > 0.7.</p><p>CONCLUSION: Clinical risk scores may guide a personalized evaluation approach in CS patients. Increasing awareness of the usage of available AF-predicting scores may optimize the arrhythmia detection pathway in stroke units.</p>}},
author = {{Ratajczak-Tretel, B and Lambert, A Tancin 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 K and Halvorsen, B and Høie, G A and Ihle-Hansen, H and Ihle-Hansen, H. and Ingebrigtsen, S 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, Anne Hege}},
issn = {{1432-1459}},
language = {{eng}},
month = {{05}},
number = {{8}},
pages = {{4049--4059}},
publisher = {{Springer}},
series = {{Journal of Neurology}},
title = {{Prediction of underlying atrial fibrillation in patients with a cryptogenic stroke : results from the NOR-FIB Study}},
url = {{http://dx.doi.org/10.1007/s00415-023-11680-8}},
doi = {{10.1007/s00415-023-11680-8}},
volume = {{270}},
year = {{2023}},
}