Development and Validation of a Novel Score for Predicting Paroxysmal Atrial Fibrillation in Acute Ischemic Stroke
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Sample
2.2. Statistical Analysis
2.3. Risk Score Development and Internal Validation
3. Results
3.1. Baseline Characteristics
3.2. Score Development and Validation
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Acute Ischemic Stroke | p Value | ||||
---|---|---|---|---|---|
Total (N = 6033) | Without AF (N = 5016) | With pAF (N = 274) | With Sustained AF (N = 743) | ||
Age, years | 67 (57–76) | 65 (55–75) | 74 (65–81) * | 74 (65–81) ** | <0.001 |
Male | 3921 (65.0) | 3342 (66.6) | 157 (57.3) * | 422 (56.8) ** | <0.001 |
eNIHSS | 4 (4–9) | 4 (4–7) | 4 (4−11) * | 4 (4–11) ** | <0.001 |
eNIHSS ≤ 5 | 4009 (66.5) | 3511 (70.0) | 153 (55.8) | 345 (46.4) | |
eNIHSS 6–13 | 1151 (19.1) | 929 (18.5) | 58 (21.2) | 164 (22.1) | |
eNIHSS > 13 | 873 (14.5) | 576 (11.5) | 63 (23.0) | 234 (31.5) | |
Hypertension | 4391 (72.8) | 3663 (73.0) | 206 (75.2) | 522 (70.3) | 0.188 |
Diabetes mellitus | 2169 (36.0) | 1874 (37.4) | 83 (30.3) | 212 (28.5) ** | <0.001 |
Dyslipidemia | 2956 (49.0) | 2595 (51.7) | 92 (33.6) * | 269 (36.2) ** | <0.001 |
Congestive heart failure | 334 (5.5) | 212 (4.2) | 27 (9.9) * | 95 (12.8) ** | <0.001 |
Coronary artery disease | 578 (9.6) | 445 (8.9) | 40 (14.6) * | 93 (12.5) ** | < 0.001 |
Current smoker | 1839 (30.5) | 1631 (32.5) | 65 (23.7) * | 143 (19.2) ** | < 0.001 |
Prior stroke or TIA | 1280 (21.2) | 1058 (21.1) | 53 (19.3) | 169 (22.7) | 0.436 |
Total cholesterol, mmol/L | 4.53 (3.91–5.23) | 4.58 (3.96–5.31) | 4.30 (3.76–4.92) * | 4.30 (3.68–4.92) ** | <0.001 |
Triglyceride, mmol/L | 1.24 (0.89–1.79) | 1.31 (0.94–1.86) | 1.04 (0.79–1.54) * | 0.96 (0.70–1.32) ** | <0.001 |
Creatinine, μmol/L | 84.86 (68.95–107.85) | 83.98 (68.95–106.96) | 89.28 (72.49–113.15) | 88.40 (70.72–112.27) ** | 0.002 |
ALT, U/L | 21 (16–29) | 21 (16–29) | 20 (15–27) | 20 (15–28) ** | 0.006 |
Mean SBP, mmHg | 148.3 (135.4–162.8) | 149.4 (136.4–164.1) | 144.6 (132.5–158.5) * | 142.1 (132.6–155.8) ** | <0.001 |
Mean DBP, mmHg | 83.5 (76.8–91.1) | 84.0 (77.1–91.8) | 79.8 (73.9–87.2) * | 81.8 (75.5–89.2) ** | <0.001 |
Mean HR, bpm | 73.4 (66.4–80.3) | 72.7 (65.9–79.4) | 73.8 (66.2–81.1) | 77.8 (70.2–87.8) ** | <0.001 |
SD of HR, bpm | 6.9 (5.1–9.3) | 6.6 (5.0–8.6) | 8.6 (6.2–12.4) * | 9.5 (7.2–12.4) ** | <0.001 |
CV of HR | 0.09 (0.07–0.12) | 0.09 (0.07–0.12) | 0.12 (0.09–0.16) * | 0.12 (0.09–0.15) ** | <0.001 |
β-Coefficient | OR | 95% CI | p Value | Points | |
---|---|---|---|---|---|
Age (per 10 years) | 0.522 | 1.69 | 1.48–1.92 | <0.001 | 2 |
Coronary artery disease | 0.576 | 1.78 | 1.16–2.72 | 0.008 | 2 |
Dyslipidemia | −0.513 | 0.60 | 0.43–0.83 | 0.002 | −2 |
SD of heart rate (per 3 bpm) | 0.439 | 1.55 | 1.38–1.75 | <0.001 | 2 |
Mean SBP (per 20 mmHg) | −0.240 | 0.79 | 0.67–0.93 | 0.005 | −1 |
Risk Score | Risk Category | N (%) | Detection Rate of pAF |
---|---|---|---|
≤7 | Low | 1757 (33.2) | 0.8% |
8–14 | Medium | 2992 (56.6) | 5.5% |
≥15 | High | 541 (10.2) | 18.3% |
Overall | 5290 (100) | 5.2% |
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Lee, J.-D.; Kuo, Y.-W.; Lee, C.-P.; Huang, Y.-C.; Lee, M.; Lee, T.-H. Development and Validation of a Novel Score for Predicting Paroxysmal Atrial Fibrillation in Acute Ischemic Stroke. Int. J. Environ. Res. Public Health 2022, 19, 7277. https://doi.org/10.3390/ijerph19127277
Lee J-D, Kuo Y-W, Lee C-P, Huang Y-C, Lee M, Lee T-H. Development and Validation of a Novel Score for Predicting Paroxysmal Atrial Fibrillation in Acute Ischemic Stroke. International Journal of Environmental Research and Public Health. 2022; 19(12):7277. https://doi.org/10.3390/ijerph19127277
Chicago/Turabian StyleLee, Jiann-Der, Ya-Wen Kuo, Chuan-Pin Lee, Yen-Chu Huang, Meng Lee, and Tsong-Hai Lee. 2022. "Development and Validation of a Novel Score for Predicting Paroxysmal Atrial Fibrillation in Acute Ischemic Stroke" International Journal of Environmental Research and Public Health 19, no. 12: 7277. https://doi.org/10.3390/ijerph19127277