The Decryptoring Score for detecting occult atrial fibrillation in cryptogenic stroke is undergoing prospective validation, with over 90% of the planned cohort enrolled demonstrating strong feasibility.
Observational
Does the Decryptoring Score accurately predict occult atrial fibrillation in patients aged ≥50 years with ischemic stroke or TIA?
A prospective validation study of the Decryptoring Score for detecting occult atrial fibrillation in cryptogenic stroke is currently underway and highly feasible.
Abstract Background and aims In up to one-third of ischemic stroke cases, no definite cause is identified, classifying them as cryptogenic strokes, often falling under the concept of embolic stroke of undetermined source (ESUS). Occult atrial fibrillation (AF) is frequently encountered and an often undetected source, owing to its paroxysmal and asymptomatic nature. Current monitoring strategies, including Holter and implantable loop recorders, show variable detection rates. The Decryptoring Score (PMID: 34689053) integrates clinical, echocardiographic, and biomarker parameters to predict AF in cryptogenic stroke and to identify who may benefit from prolonged rhythm monitoring. This study aims to prospectively validate its diagnostic performance regarding sensitivity, specificity, predictive values, and AUC. Methods Consecutive patients aged ≥50 years with ischemic stroke or transient ischemic attack (TIA) are prospectively enrolled. Based on an expected atrial fibrillation (AF) prevalence of approximately 15%, the study aims to recruit at least 100 patients to ensure adequate statistical power for validating the diagnostic performance of the Decryptoring Score. All participants undergo continuous in-hospital ECG monitoring using a telemetric AF detection system (SRA+, Apoplex Medical Technologies), followed by 7–15 days of ambulatory Holter monitoring and analysis by an independent core laboratory. Echocardiography includes standardized left atrial strain (LAS) assessment with a temporal resolution of ≥50 Hz. NT-proBNP, troponin (hs-TnT), comorbidities, and relevant laboratory parameters are systematically recorded. Results Patient recruitment is nearing completion, with more than 90% of the planned cohort enrolled. Preliminary evaluations indicate high data quality and strong feasibility of this comprehensive diagnostic approach. Conflict of interest nothing to disclose
Maliandi et al. (Fri,) conducted a observational in Cryptogenic stroke or transient ischemic attack (TIA). Decryptoring Score was evaluated on Diagnostic performance regarding sensitivity, specificity, predictive values, and AUC for predicting atrial fibrillation. The Decryptoring Score for detecting occult atrial fibrillation in cryptogenic stroke is undergoing prospective validation, with over 90% of the planned cohort enrolled demonstrating strong feasibility.