Development and Validation of a Novel Score for Predicting Paroxysmal Atrial Fibrillation in Acute Ischemic Stroke

• Published in: International journal of environmental research and public health 2022-06, Vol.19 (12), p.7277
• Main Authors: Lee, Jiann-Der, Kuo, Ya-Wen, Lee, Chuan-Pin, Huang, Yen-Chu, Lee, Meng, Lee, Tsong-Hai
• Format: Article
• Language: English
• Subjects: Atrial Fibrillation - diagnosis; Atrial Fibrillation - epidemiology; Blood pressure; Calibration; Cardiac arrhythmia; Cardiovascular disease; Child; Codes; Coronary artery; Coronary Artery Disease; Dyslipidemia; Electrocardiography; Electrocardiography, Ambulatory; Fibrillation; Health risks; Heart diseases; Heart failure; Heart rate; Hospitalization; Humans; Intensive care; Ischemia; Ischemic Stroke; Laboratories; Monitoring; Patients; Prediction models; Predictive Value of Tests; Regression analysis; Risk; Risk Factors; Standard deviation; Stroke; Telemedicine; Transient ischemic attack
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph19127277

Atrial fibrillation (AF)-whether paroxysmal or sustained-increases the risk of stroke. We developed and validated a risk score for identifying patients at risk of paroxysmal atrial fibrillation (pAF) after acute ischemic stroke (AIS). A total of 6033 patients with AIS who received 24 h Holter monitoring were identified in the Chang Gung Research Database. Among the identified patients, 5290 with pAF and without AF were included in the multivariable logistic regression analysis to develop the pAF prediction model. The ABCD-SD score ( ge, Systolic lood pressure, oronary artery disease, yslipidemia, and tandard eviation of heart rate) comprises age (+2 points for every 10 years), systolic blood pressure (-1 point for every 20 mmHg), coronary artery disease (+2 points), dyslipidemia (-2 points), and standard deviation of heart rate (+2 points for every 3 beats per minute). Overall, 5.2% (274/5290) of patients had pAF. The pAF risk ranged from 0.8% (ABCD-SD score ≤ 7) to 18.3% (ABCD-SD score ≥ 15). The model achieved an area under the receiver operating characteristic curve (AUROCC) of 0.767 in the model development group. The ABCD-SD score could aid clinicians in identifying patients with AIS at risk of pAF for advanced cardiac monitoring.