Prediction of underlying atrial fibrillation in patients with a cryptogenic stroke: results from the NOR-FIB Study
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Prediction of underlying atrial fibrillation in patients with a cryptogenic stroke : results from the NOR-FIB Study. / Ratajczak-Tretel, B.; Lambert, A. Tancin; Al-Ani, R.; Arntzen, K.; Bakkejord, G. K.; Bekkeseth, H. M. O.; Bjerkeli, V.; Eldøen, G.; Gulsvik, A. K.; Halvorsen, B.; Høie, G. A.; Ihle-Hansen, H.; Ihle-Hansen, H.; Ingebrigtsen, S.; Kremer, C.; Krogseth, S. B.; Kruuse, C.; Kurz, M.; Nakstad, I.; Novotny, V.; Næss, H.; Qazi, R.; Rezaj, M. K.; Rørholt, D. M.; Steffensen, L. H.; Sømark, J.; Tobro, H.; Truelsen, T. C.; Wassvik, L.; Ægidius, K. L.; Atar, D.; Aamodt, Anne Hege; NOR-FIB study group.
I: Journal of Neurology, Bind 270, Nr. 8, 2023, s. 4049-4059.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Prediction of underlying atrial fibrillation in patients with a cryptogenic stroke
T2 - results from the NOR-FIB Study
AU - Ratajczak-Tretel, B.
AU - Lambert, A. Tancin
AU - Al-Ani, R.
AU - Arntzen, K.
AU - Bakkejord, G. K.
AU - Bekkeseth, H. M. O.
AU - Bjerkeli, V.
AU - Eldøen, G.
AU - Gulsvik, A. K.
AU - Halvorsen, B.
AU - Høie, G. A.
AU - Ihle-Hansen, H.
AU - Ihle-Hansen, H.
AU - Ingebrigtsen, S.
AU - Kremer, C.
AU - Krogseth, S. B.
AU - Kruuse, C.
AU - Kurz, M.
AU - Nakstad, I.
AU - Novotny, V.
AU - Næss, H.
AU - Qazi, R.
AU - Rezaj, M. K.
AU - Rørholt, D. M.
AU - Steffensen, L. H.
AU - Sømark, J.
AU - Tobro, H.
AU - Truelsen, T. C.
AU - Wassvik, L.
AU - Ægidius, K. L.
AU - Atar, D.
AU - Aamodt, Anne Hege
AU - NOR-FIB study group
N1 - Publisher Copyright: © 2023, The Author(s).
PY - 2023
Y1 - 2023
N2 - 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, CHA2DS2-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.
AB - 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, CHA2DS2-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.
KW - Atrial fibrillation
KW - Biomarkers
KW - Cryptogenic stroke
KW - ICM
KW - Prediction scores
KW - Predictors
U2 - 10.1007/s00415-023-11680-8
DO - 10.1007/s00415-023-11680-8
M3 - Journal article
C2 - 37162578
AN - SCOPUS:85159044657
VL - 270
SP - 4049
EP - 4059
JO - Deutsche Zeitschrift fur Nervenheilkunde
JF - Deutsche Zeitschrift fur Nervenheilkunde
SN - 0939-1517
IS - 8
ER -
ID: 362744197