Methods Article for a Study Protocol: Refining Stroke Prediction in Atrial Fibrillation Patients in an Ethnically...

Area of Science:

• Cardiology
• Neurology
• Public Health

Background:

• Atrial fibrillation (AF) significantly increases ischaemic stroke (IS) risk, necessitating accurate prediction models for anticoagulation guidance.
• Current risk scores, like CHA2DS2VASc, are validated primarily in European cohorts, potentially limiting their accuracy in diverse populations.
• Local refinement of risk prediction tools is recommended by cardiology guidelines to enhance clinical decision-making.

Purpose of the Study:

• To analyze trends in AF-associated IS prevalence in Auckland.
• To validate the CHA2DS2VASc score and evaluate the impact of incorporating ethnicity (Māori and Pacific peoples) on risk prediction accuracy.
• To identify factors associated with anticoagulant failure in AF patients.

Main Methods:

• Utilizing data from the Auckland Regional Community Stroke Study (ARCOS IV and V) and the National Minimum Dataset (NMD).
• Employing a nested case-control design to assess CHA2DS2VASc performance and ethnic-specific refinements.
• Analyzing stroke aetiology, antithrombotic prescribing, and potential interactions.

Main Results:

• This section is not available in the provided abstract.

Conclusions:

• Population-level data analysis will illuminate AF burden, management trends, and treatment failure associations.
• The study will address critical knowledge gaps regarding the management of AF-related stroke in ethnically diverse populations.
• Reporting will comply with Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) guidelines.