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Documentation of atrial fibrillation prior to first-ever ischemic stroke

M A Baturova1, A Lindgren, Y V Shubik

  • 1Department of Cardiology, Lund University, Lund, Sweden; North-West Center for Diagnostics and Treatment of Arrythmias, St.Petersburg State University, St. Petersburg, Russia.

Acta Neurologica Scandinavica
|December 5, 2013
PubMed

Insights

A comprehensive screening approach detected atrial fibrillation (AF) in one-third of patients with their first ischemic stroke. High cardiovascular risk patients were more likely to have non-permanent AF.

Area of Science:

  • Cardiology
  • Neurology
  • Public Health

Background:

  • Atrial fibrillation (AF) is a significant risk factor for ischemic stroke.
  • Early detection of AF is crucial for stroke prevention and management.
  • Previous studies have varied in their assessment of AF prevalence prior to stroke.

Purpose of the Study:

  • To determine the prevalence of atrial fibrillation (AF) before first-ever ischemic stroke.
  • To evaluate the effectiveness of a comprehensive screening approach including electronic ECG and national registries.
  • To investigate the association between cardiovascular risk scores and AF detection in stroke patients.

Main Methods:

  • A cohort of 336 first-ever ischemic stroke patients and 336 matched controls were analyzed.
  • Electronic ECG archives and the National Swedish Hospital Discharge Register (SHDR) were utilized for AF detection.
  • Medical records were reviewed for AF documentation and CHA2DS2-VASc risk score calculation.

Main Results:

  • AF was detected in 32.4% of stroke patients compared to 13.1% of controls (P<0.001).
  • A significant portion of AF cases (25/109) were identified through previous ECGs or SHDR.
  • Non-permanent AF was the most prevalent type (59.6%) in the stroke group. AF prevalence was higher in stroke patients with CHA2DS2-VASc score ≥6 (28.6%) versus <6 (13.0%).

Conclusions:

  • A comprehensive screening strategy can identify AF in approximately one-third of patients presenting with their first ischemic stroke.
  • Patients with a high cardiovascular risk (CHA2DS2-VASc score ≥6) have a greater likelihood of having non-permanent AF.
  • These findings highlight the importance of thorough AF screening in stroke patients, particularly those with elevated cardiovascular risk.
Abstract

Keywords:
ECGatrial fibrillationfirst-ever ischemic strokestroke register

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