title: Predictors of new onset atrial fibrillation during 10-year follow-up after first-ever ischemic stroke.
abstract: BACKGROUND
  Paroxysmal atrial fibrillation (AF) may be underdiagnosed in ischemic stroke patients but may be pivotal for initiation of oral anticoagulation therapy. We assessed clinical and ECG predictors of new-onset AF during 10-year follow-up (FU) in ischemic stroke patients.
  
  
  METHODS
  The study sample comprised of 227 first-ever ischemic stroke patients without AF (median age 73, interquartile range 25%-75% 63-80years, 92 female) and 1:1 age- and gender-matched controls without stroke and AF enrolled in the Lund Stroke Register from March 2001 to February 2002. New-onset AF during FU was assessed by screening through regional ECG database and by record linkage with Swedish National Patient Register. The standard 12-lead sinus rhythm ECGs at stroke admission were retrieved from electronic database and digitally processed. Clinical baseline characteristics were studied using medical records.
  
  
  RESULTS
  During FU, AF was found in 39 stroke patients and 30 controls, p=0.296. In stroke patients in multivariate Cox regression analysis AF was associated with hypertension (HR 3.45 CI 95% 1.40-3.49, p=0.007) and QRS duration (HR 1.02 CI 95% 1.00-1.03, p=0.049). High cardiovascular risk was predictive for AF development: for CHADS2≥4 HR 2.46 CI 95% 1.45-4.18, p=0.001 and for CHA2DS2-VASc≥5 HR 2.29 CI 95% 1.43-3.68, p=0.001. New onset AF was not associated with baseline ischemic stroke: HR 1.46 95% CI 0.90-2.35, p=0.121.
  
  
  CONCLUSIONS
  High CHADS2 and CHA2DS2-VASc scores, but not baseline ischemic stroke, predict new onset AF in FU. QRS duration might be considered a potential risk marker for prediction of AF after ischemic stroke.
authors.affiliation: Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden; St. Petersburg University Clinic, St. Petersburg, Russia; Cardiology Research, Clinical and Educational Center, St. Petersburg State University, St. Petersburg, Russia. Electronic address: Maria.Baturova@med.lu.se.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Baturova
authors.affiliation: Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden; Department of Clinical Sciences Lund, Neurology, Lund University, Sweden.
authors.forename: Arne
authors.initials: A
authors.lastname: Lindgren
authors.affiliation: Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Jonas
authors.initials: J
authors.lastname: Carlson
authors.affiliation: St. Petersburg University Clinic, St. Petersburg, Russia; Cardiology Research, Clinical and Educational Center, St. Petersburg State University, St. Petersburg, Russia.
authors.forename: Yuri V
authors.initials: YV
authors.lastname: Shubik
authors.affiliation: Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: S Bertil
authors.initials: SB
authors.lastname: Olsson
authors.affiliation: Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden; Arrythmia Clinic, Skåne University Hospital, Lund, Sweden.
authors.forename: Pyotr G
authors.initials: PG
authors.lastname: Platonov
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D002545:Brain Ischemia / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D013548:Sweden / Q000453:epidemiology; D013614:Tachycardia, Paroxysmal / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*
chemical_list: D000925:Anticoagulants
keywords: Atrial fibrillation; CHA2DS2-VASc; CHADS2; ECG; Ischemic stroke; Predictors