Atrial fibrillation in cryptogenic stroke and TIA patients in The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study: Main results
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
Atrial fibrillation in cryptogenic stroke and TIA patients in The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study : Main results. / Ratajczak-Tretel, B.; Tancin Lambert, A.; Al-Ani, R.; Arntzen, K.; Bakkejord, G. K.; Bekkeseth, H. M. O.; Bjerkeli, V.; Eldøen, G.; Gulsvik, A.; Halvorsen, B.; Høie, G. A.; Ihle-Hansen, H.; Ihle-Hansen, H.; Ihle-Hansen, H.; Ingebrigtsen, S.; Johansen, H.; Kremer, C.; Krogseth, S. B.; Kruuse, C.; Kurz, M.; Nakstad, I.; Novotny, V.; Næss, H.; Qazi, R.; Rezaj, M. K.; Rørholt, D. M.; Steffensen, L. H.; Sømark, J.; Tobro, H.; Truelsen, T. C.; Wassvik, L.; Ægidius, K. L.; Atar, D.; Aamodt, A. H.
I: European Stroke Journal, Bind 8, Nr. 1, 2023, s. 148-156.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Atrial fibrillation in cryptogenic stroke and TIA patients in The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study
T2 - Main results
AU - Ratajczak-Tretel, B.
AU - Tancin Lambert, A.
AU - Al-Ani, R.
AU - Arntzen, K.
AU - Bakkejord, G. K.
AU - Bekkeseth, H. M. O.
AU - Bjerkeli, V.
AU - Eldøen, G.
AU - Gulsvik, A.
AU - Halvorsen, B.
AU - Høie, G. A.
AU - Ihle-Hansen, H.
AU - Ihle-Hansen, H.
AU - Ihle-Hansen, H.
AU - Ingebrigtsen, S.
AU - Johansen, H.
AU - Kremer, C.
AU - Krogseth, S. B.
AU - Kruuse, C.
AU - Kurz, M.
AU - Nakstad, I.
AU - Novotny, V.
AU - Næss, H.
AU - Qazi, R.
AU - Rezaj, M. K.
AU - Rørholt, D. M.
AU - Steffensen, L. H.
AU - Sømark, J.
AU - Tobro, H.
AU - Truelsen, T. C.
AU - Wassvik, L.
AU - Ægidius, K. L.
AU - Atar, D.
AU - Aamodt, A. H.
N1 - Publisher Copyright: © The Author(s) 2022.
PY - 2023
Y1 - 2023
N2 - Introduction: Secondary stroke prevention depends on proper identification of the underlying etiology and initiation of optimal treatment after the index event. The aim of the NOR-FIB study was to detect and quantify underlying atrial fibrillation (AF) in patients with cryptogenic stroke (CS) or transient ischaemic attack (TIA) using insertable cardiac monitor (ICM), to optimise secondary prevention, and to test the feasibility of ICM usage for stroke physicians. Patients and methods: Prospective observational international multicenter real-life study of CS and TIA patients monitored for 12 months with ICM (Reveal LINQ) for AF detection. Results: ICM insertion was performed in 91.5% by stroke physicians, within median 9 days after index event. Paroxysmal AF was diagnosed in 74 out of 259 patients (28.6%), detected early after ICM insertion (mean 48 ± 52 days) in 86.5% of patients. AF patients were older (72.6 vs 62.2; p < 0.001), had higher pre-stroke CHA₂DS₂-VASc score (median 3 vs 2; p < 0.001) and admission NIHSS (median 2 vs 1; p = 0.001); and more often hypertension (p = 0.045) and dyslipidaemia (p = 0.005) than non-AF patients. The arrhythmia was recurrent in 91.9% and asymptomatic in 93.2%. At 12-month follow-up anticoagulants usage was 97.3%. Discussion and conclusions: ICM was an effective tool for diagnosing underlying AF, capturing AF in 29% of the CS and TIA patients. AF was asymptomatic in most cases and would mainly have gone undiagnosed without ICM. The insertion and use of ICM was feasible for stroke physicians in stroke units.
AB - Introduction: Secondary stroke prevention depends on proper identification of the underlying etiology and initiation of optimal treatment after the index event. The aim of the NOR-FIB study was to detect and quantify underlying atrial fibrillation (AF) in patients with cryptogenic stroke (CS) or transient ischaemic attack (TIA) using insertable cardiac monitor (ICM), to optimise secondary prevention, and to test the feasibility of ICM usage for stroke physicians. Patients and methods: Prospective observational international multicenter real-life study of CS and TIA patients monitored for 12 months with ICM (Reveal LINQ) for AF detection. Results: ICM insertion was performed in 91.5% by stroke physicians, within median 9 days after index event. Paroxysmal AF was diagnosed in 74 out of 259 patients (28.6%), detected early after ICM insertion (mean 48 ± 52 days) in 86.5% of patients. AF patients were older (72.6 vs 62.2; p < 0.001), had higher pre-stroke CHA₂DS₂-VASc score (median 3 vs 2; p < 0.001) and admission NIHSS (median 2 vs 1; p = 0.001); and more often hypertension (p = 0.045) and dyslipidaemia (p = 0.005) than non-AF patients. The arrhythmia was recurrent in 91.9% and asymptomatic in 93.2%. At 12-month follow-up anticoagulants usage was 97.3%. Discussion and conclusions: ICM was an effective tool for diagnosing underlying AF, capturing AF in 29% of the CS and TIA patients. AF was asymptomatic in most cases and would mainly have gone undiagnosed without ICM. The insertion and use of ICM was feasible for stroke physicians in stroke units.
KW - anticoagulation
KW - arrhythmia monitoring
KW - atrial fibrillation
KW - biomarkers
KW - Cryptogenic stroke
KW - insertable cardiac monitor
KW - secondary prevention
U2 - 10.1177/23969873221123122
DO - 10.1177/23969873221123122
M3 - Journal article
C2 - 37021182
AN - SCOPUS:85140592455
VL - 8
SP - 148
EP - 156
JO - European Stroke Journal
JF - European Stroke Journal
SN - 2396-9873
IS - 1
ER -
ID: 328730448