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Prevalence and Characteristics of Known versus Newly Detected Atrial Fibrillation in Ischemic Stroke: A

Aurore Mitaine1,2, Gauthier Duloquin1,3, Thibaut Pommier1,4

  • 1Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cardiocerebrovascular Diseases (PEC2), University of Burgundy, Dijon, France.

Neuroepidemiology
|March 12, 2024
PubMed

Insights

Atrial fibrillation (AF) diagnosed after ischemic stroke (IS) suggests missed prevention opportunities. Patients with AF diagnosed after IS showed less advanced atrial cardiomyopathy than those with known AF before stroke.

Area of Science:

  • Cardiology
  • Neurology
  • Epidemiology

Background:

  • Atrial fibrillation (AF) is often diagnosed during acute ischemic stroke (IS), indicating potential pre-stroke undiagnosed AF and missed prevention opportunities.
  • This study assessed the prevalence of known AF (KAF) and AF diagnosed early after IS (AFDAS).

Purpose of the Study:

  • To evaluate the prevalence of KAF versus AFDAS in ischemic stroke patients.
  • To compare clinical and neuroimaging characteristics between KAF and AFDAS groups.
  • To identify factors associated with AFDAS diagnosis.

Main Methods:

  • Analysis of ischemic stroke patients from the Dijon Stroke Registry (2013-2020).
  • Identification of patients with KAF or AFDAS (diagnosed during initial stroke work-up).
  • Comparison of clinical data and brain/arterial imaging (CT, angio-CT) between groups, using logistic regression for associated factors.

Main Results:

  • Of 1,756 IS patients, 550 (31.3%) had AF: 367 (66.7%) with KAF and 183 (33.3%) with AFDAS.
  • Hypertension, chronic heart failure, previous stroke, and dementia were inversely associated with AFDAS.
  • Higher NIHSS score was associated with AFDAS.

Conclusions:

  • Patients with AFDAS appear to have less advanced atrial cardiomyopathy compared to KAF patients.
  • This suggests a potential reason for pre-stroke AF diagnosis failure in the AFDAS group.
  • The AFDAS group represents a significant missed opportunity for primary stroke prevention.
Abstract

Keywords:
Atrial fibrillationAtrial fibrillation detected after strokeIschemic strokeKnown atrial fibrillationPopulation-based studyRegistry

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