title: Predictors of newly diagnosed atrial fibrillation in cryptogenic stroke: a cohort study.
abstract: OBJECTIVE
  A significant proportion of cryptogenic ischaemic strokes are due to paroxysmal atrial fibrillation (AF). As paroxysmal AF appears to inexorably progress to persistent or permanent AF, this study with long-term follow-up was designed to establish the profile of patients who developed AF after hospital discharge.
  
  
  METHODS
  All patients with cryptogenic ischaemic stroke over a 1-year period were included (n = 164). Patients were prospectively followed up at the outpatient clinic. Information on long-term outcome included the presence of newly diagnosed AF (NDAF). A specific NDAF assessment was performed at least 2 years after the index stroke using a structured telephone interview. Baseline clinical, laboratory, and echocardiographic data of these patients were retrospectively recorded. Independent predictive factors were then used to produce a predictive grading score for NDAF, derived by logistic regression analysis.
  
  
  RESULTS
  With a median follow-up of 854 days, 22 cases of NDAF (13%) were observed. On multivariate analysis, factors associated with NDAF were age ≥72 years (two points), history of coronary artery disease (one point) or stroke (one point), and left atrial area ≥16 cm(2) (two points) (total score ranging from 0 to 6). Patients with a score ≤1 point did not have NDAF during follow-up.
  
  
  CONCLUSIONS
  In cryptogenic ischaemic stroke, the NDAF score can be used to target patients at high risk of developing AF after hospital discharge, as a score of 0-1 was highly predictive of the absence of NDAF during follow-up. These results need to be confirmed in prospective studies.
authors.affiliation: Department of Neurology, Amiens University Hospital, Amiens, France; Laboratory of Functional Neurosciences and Pathology (EA 4559), Amiens, France; INSERM U1088, Amiens, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Bugnicourt
authors.forename: M
authors.initials: M
authors.lastname: Flament
authors.forename: M-P
authors.initials: MP
authors.lastname: Guillaumont
authors.forename: J-M
authors.initials: JM
authors.lastname: Chillon
authors.forename: C
authors.initials: C
authors.lastname: Leclercq
authors.forename: S
authors.initials: S
authors.lastname: Canaple
authors.forename: C
authors.initials: C
authors.lastname: Lamy
authors.forename: O
authors.initials: O
authors.lastname: Godefroy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001281:Atrial Fibrillation / Q000150:complications* / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012307:Risk Factors; D020521:Stroke / Q000150:complications*
keywords: atrial fibrillation; ischaemic stroke; outcome; secondary prevention