Score for the targeting of atrial fibrillation (STAF): a new approach to the detection of atrial fibrillation in the secondary prevention of ischemic stroke.
OBJECTIVE
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.
Suissa
Laurent
L
Centre Hospitalier de Nice - Hôpital Saint Roch, Unité neurovasculaire - Soins Intensifs, 5, Rue Pierre Devoluy, 06 000 Nice, France. Laurent.suissa@wanadoo.fr
Bertora
David
D
Lachaud
Sylvain
S
Mahagne
Marie Hélène
MH
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000145:classification* / Q000150:complications / Q000175:diagnosis*; D002545:Brain Ischemia / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D055502:Secondary Prevention / Q000379:methods*; D012680:Sensitivity and Specificity; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*