Key result
AS5F score accurately identifies ischemic stroke patients at high risk for pAF with NNS of 3.
Why the study?
Prolonged ECG monitoring for 72 hours is recommended to detect paroxysmal atrial fibrillation after ischemic stroke but is not yet routine clinical practice, necessitating a method to select patients for monitoring efficiently.
Does the AS5F score accurately identify patients with ischemic stroke at a higher risk of paroxysmal atrial fibrillation?
Population
1,556 patients with TIA or ischemic stroke in sinus rhythm
Comparison
Use of AS5F clinical score to select patients for prolonged ECG monitoring vs no score-based selection
Design
Cohort study with internal and external validation following TRIPOD guidelines
Follow-up
72 hours
Authors
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May enhance post-stroke AF screening yield; leaves open need for prospective validation before practice change.
Cohort (n=1,556)
Yes
Does the AS5F score accurately identify patients with ischemic stroke at a higher risk of paroxysmal atrial fibrillation?
Number Needed to Treat: 3
Number Needed to Treat: 3
p-value: p=< 0.001
The AS5F score, utilizing age and stroke severity, can effectively identify patients with ischemic stroke who are at high risk for paroxysmal atrial fibrillation to optimize the diagnostic yield of prolonged ECG monitoring.
Uphaus et al. (2018) conducted a cohort in TIA or ischemic stroke (n=1,556). AS5F score (Age and Stroke Severity) was evaluated on Detection of paroxysmal atrial fibrillation (pAF) within 72 hours of Holter monitoring (p=< 0.001). The AS5F score, based on age and stroke severity, accurately identified patients with ischemic stroke at high risk for paroxysmal atrial fibrillation, with a number needed to screen of 3.
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