Score for the targeting of atrial fibrillation (STAF): a new approach to the detection of atrial fibrillation in the secondary prevention of ischemic stroke.

摘要

BACKGROUND AND PURPOSE: The high risk of recurrence and comorbidity after a stroke associated with atrial fibrillation (AF) justifies an aggressive diagnostic approach so that anticoagulant treatment can be initiated. METHODS: The clinical and paraclinical characteristics of consecutive ischemic stroke patients with and without documented AF were recorded. Independent predictive factors were then used to produce a predictive grading score for diagnosing AF, derived by logistic regression analysis: Score for the Targeting of Atrial Fibrillation (STAF). RESULTS: STAF, calculated from the sum of the points for the 4 items (possible total score 0 to 8): age >62 years (2 points); NIHSS > or =8 (1 point); left atrial dilatation (2 points); absence of symptomatic intraor extracranial stenosis > or =50%, or clinico-radiological lacunar syndrome (3 points). STAF > or =5 identified patients with AF with a sensitivity of 89% and a specificity of 88%. CONCLUSIONS: STAF can be used as part of a novel and simple strategy for the targeting of AF in the secondary prevention of ischemic stroke. A multicenter study is now required to validate STAF in a larger number of patients.