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

Jiann- Der Lee, Ya-Wen Kuo, Chuan-Pin Lee, Yen-Chu Huang, Meng Lee and Tsong-Hai Lee
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Jiann- Der Lee: Department of Neurology, Chiayi Chang Gung Memorial Hospital, No. 6, West Sec., Jiapu Road, Puzi City 613, Taiwan
Ya-Wen Kuo: Department of Neurology, Chiayi Chang Gung Memorial Hospital, No. 6, West Sec., Jiapu Road, Puzi City 613, Taiwan
Chuan-Pin Lee: Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
Yen-Chu Huang: Department of Neurology, Chiayi Chang Gung Memorial Hospital, No. 6, West Sec., Jiapu Road, Puzi City 613, Taiwan
Meng Lee: Department of Neurology, Chiayi Chang Gung Memorial Hospital, No. 6, West Sec., Jiapu Road, Puzi City 613, Taiwan
Tsong-Hai Lee: College of Medicine, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan 333, Taiwan

IJERPH, 2022, vol. 19, issue 12, 1-11

Abstract: 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 ( A ge, Systolic B lood pressure, C oronary artery disease, D yslipidemia, and S tandard D 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.

Keywords: ischemic stroke; atrial fibrillation; heart rate; risk (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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