Prediction of occult atrial fibrillation in patients after cryptogenic stroke and transient ischaemic attack: PROACTIA

• DOI: 10.1093/europace/euac092
• Publication Date: 2022-07-12T12:29:31Z
• Authors: Loreta Skrebelyte...; Ole Morten Rønning; Fredrik A Dahl; Kjetil Steine; Harald Kjekshus
• Keywords: Stroke; Quartile; Subclinical infection

Abstract Aims Studies with implantable cardiac monitors (ICMs) show that one-third of patients cryptogenic stroke/transient ischaemic attack (TIA) have episodes subclinical atrial fibrillation (SCAF) and benefit switching from antiplatelet- to anticoagulant therapy. However, ICMs are costly resource demanding. We aimed build a score based on participant’s baseline characteristics could assess individual risk SCAF. Methods results In prospective study, 236 eligible final diagnosis stroke/TIA had an ICM implantated during the index hospitalization. Pre-specified evaluated variables were: CHA2DS2-VASc, P-wave duration, morphology, premature beats (PAC)/24 h, supraventricular tachycardia/24 left end-systolic volume (LAVI), Troponin-T, NT-proBNP, D-dimer. SCAF was detected in 84 (36%). All pre-specified were significantly associated detection univariate analysis. followed by PAC/24 LAVI, largest ratio prevalence between its upper lower quartiles (3.3, vs. 3.2, 3.1 2.8, respectively). multivariate analysis, only PAC/24t, LAVIs remained significant predictors included PROACTIA score. Subclinical 75% highest 10% lowest quartile 10-fold higher number burden >6 h quartile. Conclusion The can identify at subsequent detection. large difference groups may provide basis for future tailored Clinical trial registration Trial Registration: ClinicalTrials.gov; NCT02725944.