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Diagnostic value of STAF score in combination with D-dimer in cardioembolism

Li-Bin Liu1, Ya-Dong Guo1,2, An-Ding Xu2

  • 1Department of Neurology, Zhuhai Hospital of Jinan University, Zhuhai, China.

Plos One
|October 2, 2018
PubMed

Insights

The Score for the Targeting of Atrial Fibrillation (STAF) combined with D-dimer (DD) levels significantly improves cardioembolism diagnosis in acute ischemic stroke patients. This combination offers high sensitivity and specificity for identifying stroke causes.

Area of Science:

  • Neurology
  • Cardiology
  • Clinical Diagnostics

Background:

  • Cardioembolism (CE) is a significant cause of acute ischemic stroke.
  • Accurate etiological classification is crucial for effective stroke management and secondary prevention.
  • Existing diagnostic tools require enhancement for reliable CE detection.

Purpose of the Study:

  • To assess the diagnostic efficacy of the Score for the Targeting of Atrial Fibrillation (STAF) alone and in conjunction with serum D-dimer (DD) levels for identifying cardioembolism.
  • To evaluate the combined diagnostic performance of STAF and DD in patients with acute ischemic stroke.

Main Methods:

  • Retrospective case-only study including 317 patients with acute ischemic stroke.
  • Patients were assessed using STAF scoring criteria and classified by Trial of ORG 10172 in Acute Stroke Treatment (TOAST) etiology.
  • Serum D-dimer levels were measured and analyzed alongside STAF scores.

Main Results:

  • Out of 317 patients, 37 (11.67%) were diagnosed with CE.
  • STAF ≥5 demonstrated 89% sensitivity and 91% specificity for CE diagnosis.
  • Serum D-dimer >791.30 ng/mL showed 58% sensitivity and 78% specificity.
  • The combination of STAF and DD achieved 95% sensitivity and 100% specificity for CE.

Conclusions:

  • The STAF score, particularly when combined with serum D-dimer levels, is a highly effective tool for diagnosing cardioembolism in acute ischemic stroke.
  • This combined approach significantly enhances diagnostic accuracy, aiding in the etiological classification of stroke.
  • Integrating STAF and DD can improve patient outcomes through more precise diagnosis and targeted treatment strategies.

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