Score for the targeting of atrial fibrillation (STAF): a new approach to the detection of atrial fibrillation in the secondary prevention of ischemic stroke.

Abstract

The high risk of recurrence and comorbidity after a stroke associated with atrial fibrillation (AF) justifies an aggressive diagnostic approach so that anticoagulant treatment can be initiated. The clinical and paraclinical characteristics of consecutive ischemic stroke patients with and without documented AF were recorded. Independent predictive factors were then used to produce a predictive grading score for diagnosing AF, derived by logistic regression analysis: Score for the Targeting of Atrial Fibrillation (STAF). STAF, calculated from the sum of the points for the 4 items (possible total score 0 to 8): age >62 years (2 points); NIHSS > or =8 (1 point); left atrial dilatation (2 points); absence of symptomatic intraor extracranial stenosis > or =50%, or clinico-radiological lacunar syndrome (3 points). STAF > or =5 identified patients with AF with a sensitivity of 89% and a specificity of 88%. STAF can be used as part of a novel and simple strategy for the targeting of AF in the secondary prevention of ischemic stroke. A multicenter study is now required to validate STAF in a larger number of patients.