According to Bernardo Crespo Pimentel and colleagues, the standard diagnostic follow-up in patients after ischemic stroke may fail to detect the presence of paroxysmal atrial fibrillation. They conducted a study to assess if characteristics of ischemic stroke lesions could predict atrial fibrillation. In their report, they concluded that ischemic lesions in patients with subsequent atrial fibrillation diagnoses “presented with a more dispersed infarct pattern and a higher number of lesion components.”
The study, published in the European Stroke Journal, enrolled a total of 755 patients from the MonDAFIS study who had ischemic stroke or transient ischemic attack (TIA) without prior atrial fibrillation. First, Acute brain MRI data was examined to calculate morphological parameters.
Researchers then used multivariate logistic regression to identify associations between lesion morphology, clinical parameters, and atrial fibrillation, and stepwise elimination to identify the most important variables.
Ischemic Stroke Measure Predict Atrial Fibrillation
Reportedly, overall oriented bounding box (OBB) volume (P=.003) and number of brain lesion components (P=.008) were both larger in the 86 patients with atrial fibrillation detected within two years after stroke compared with patients without atrial fibrillation.
Based on their multivariable analysis, the researchers identified that OBB volume (odds ratio [OR], 1.72; 95% CI, 1.29-2.35; P<.001), age (OR, 2.13; 95% CI, 1.52-3.06; P<.001), and female sex (OR, 2.45; 95% CI, 1.41-4.31; P=.002) were factors independently associated with atrial fibrillation.
In their conclusion, the study’s authors suggested that “our results therefore support visual rating of ischemic lesion patterns for AF risk stratification. Whether prolonged ECG monitoring in these patients improves stroke prevention has to further investigated.”
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