This Article Full Text Full Text (PDF) All Versions of this Article: 40/8/2866    most recent STROKEAHA.109.552679v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Google Scholar Articles by Suissa, L. Articles by Mahagne, M. H. PubMed PubMed Citation Articles by Suissa, L. Articles by Mahagne, M. H. Pubmed/NCBI databases Medline Plus Health Information Atrial Fibrillation Stroke Related Collections Arterial thrombosis Echocardiography Arrhythmias, clinical electrophysiology, drugs

(Stroke. 2009;40:2866.)
© 2009 American Heart Association, Inc.

Research Letters

Score for the Targeting of Atrial Fibrillation (STAF)

A New Approach to the Detection of Atrial Fibrillation in the Secondary Prevention of Ischemic Stroke

Laurent Suissa, MD; David Bertora, MD; Sylvain Lachaud, MD Marie Hélène Mahagne, MD, PhD

From the Unité Neurovasculaire (L.S., S.L., M.H.M.), Centre Hospitalier de Nice - Hôpital Saint Roch, and the Service de Cardiologie (D.B.), Centre Hospitalier Universitaire – Hôpital Pasteur, Nice, France.

Correspondence to Laurent Suissa, Centre Hospitalier de Nice - Hôpital Saint Roch, Unité neurovasculaire – Soins Intensifs, 5, Rue Pierre Devoluy, 06 000 Nice, France. E-mail Laurent.suissa{at}wanadoo.fr

Background and Purpose— 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.

Methods— 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).

Results— STAF, calculated from the sum of the points for the 4 items (possible total score 0 to 8): age >62 years (2 points); NIHSS 8 (1 point); left atrial dilatation (2 points); absence of symptomatic intraor extracranial stenosis 50%, or clinico-radiological lacunar syndrome (3 points). STAF 5 identified patients with AF with a sensitivity of 89% and a specificity of 88%.

Conclusions— 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.

Key Words: atrial fibrillation • ischemic stroke • secondary prevention • cardioembolism • transthoracic echocardiography