The Effect of STAF Score and Clinical Data on Paroxysmal Atrial Fibrillation Determination in Patients with Cryptogenic Stroke

Abstract

Objective: To determine factors that affect paroxysmal atrial fibrillation (PAF) detection. In this regard, we evaluated the relationship between clinical and demographic data, score for the targeting of atrial fibrillation (STAF) score, CHA2DS2-VASc score, and the detection of PAF in patients with cryptogenic ischemic stroke (CIS).

Materials and Methods: This retrospective study included 98 patients who underwent 24-hour Holter electrocardiography (ECG) among 310 patients admitted to the neurology department with a diagnosis of CIS between January 2017 and July 2019. PAF was detected in Holter ECG in 49 patients. STAF score, CHA2DS2-VASc score, and demographic and clinical data were compared between patients with and without PAF.

Results: Ninety-eight patients with CIS were included in our study. The mean age of the patients was 64.4±14.1 years. Of the patients included in the study, 50% (n=49) were in the group with PAF and 50% (n=49) were in the group without PAF. The comparison of age between patients with and without PAF was statistically significant (66.98±11.9 and 59.84±15.23, respectively; p=0.01). Sex, additional risk factors, presence of vascular disease, recurrent stroke, CHA2DS2- VASc score, left atrial dilatation, left ventricular hypertrophy, mitral insufficiency, STAF score, National Institutes of Health Stroke Scale Score, and modified Rankin Scale were not significantly associated with PAF (p>0.05)

Conclusion: PAF should be investigated in strokes of unknown etiology in the elderly population. However, this study shows that STAF and CHA2DS2-VASc score, transthoracic echocardiography findings, and other risk factors are not associated with PAF detection. Future studies with longer Holter ECG recordings in larger samples will shed light on this issue.