10.5061/DRYAD.MS3M3N2
Uphaus, Timo
University Medical Center of the Johannes Gutenberg University Mainz
Weber-Krüger, Mark
University of Göttingen
Grond, Martin
Department of Neurology, Kreisklinikum Siegen
Toenges, Gerrit
University Medical Center of the Johannes Gutenberg University Mainz
Jahn-Eimermacher, Anke
Darmstadt University of Applied Sciences
Jauss, Marek
Department of Neurology, Hainich Klinikum, Mühlhausen, Germany
Kirchhof, Paulus
University Hospitals Birmingham NHS Foundation Trust
Wachter, Rolf
University Hospital Leipzig
Gröschel, Klaus
University Medical Center of the Johannes Gutenberg University Mainz
Data from: Development and validation of a score to detect paroxysmal
atrial fibrillation after stroke
Dryad
dataset
2019
Stroke prevention
Clinical Neurology
Cardiac
Infarction
Cerebrovascular disease/Stroke
2019-08-23T00:00:00Z
2019-08-23T00:00:00Z
en
https://doi.org/10.1212/wnl.0000000000006727
1215496 bytes
1
CC0 1.0 Universal (CC0 1.0) Public Domain Dedication
Objective: Prolonged monitoring times (72h) are recommended to detect
paroxysmal atrial fibrillation (pAF) after ischemic stroke, but not yet
clinical practice; therefore, an individual patient selection for
prolonged ECG monitoring might increase the diagnostic yield of pAF in a
resource-saving manner. Methods: We used individual patient data from
three prospective studies (ntotal=1556) performing prolonged Holter ECG
monitoring (at least 72h) and centralized data evaluation after TIA or
stroke in patients with sinus rhythm. Based on the TRIPOD guideline, a
clinical score was developed on one cohort, internally validated by
bootstrapping and externally validated on two other studies. Results: pAF
was detected in 77 (4.9%) of 1556 patients during 72h-Holter monitoring.
After logistic regression analysis with variable selection, age and the
qualifying stroke event (categorised as stroke severity with NIH-SS≤5 (OR
2.4 vs. TIA; 95%CI0.8-6.9,p=0.112) or stroke with NIH-SS>5 (OR 7.2
vs. TIA; 95%CI 2.4-21.8,p<0.001)) were found to be predictive for
the detection of pAF within 72h-Holter monitoring and included in the
final score (Age: 0.76 points/year, Stroke Severity NIH-SS≤5 = 9 points,
NIH-SS>5 = 21 points; to Find AF, AS5F). The high risk group
defined by AS5F is characterized by a predicted risk between 5.2% and
40.8% for detection of pAF with a number needed to screen of 3 for the
highest observed AS5F points within the study population. Regarding the
low number of outcomes before generalization of AS5F the results need
replication. Conclusion: The AS5F score can select patients for prolonged
ECG monitoring after ischemic stroke to detect pAF.
Supplemental
MaterialUphaus_AS5F_rev_suppl_180625.docUphaus_AS5F_rev_suppl_180625.pdf