No abstract

No abstract

Introduction: The intensity of AF detection modalities in stroke patients has been modulated by the stroke subtype. Hence, most studies have been performed in so called cryptogenic stroke. However, it has never been proven that AF is more prevalent in cryptogenic stroke as compared to non-cryptogenic stroke. The Find-AF randomised trial (ISRCTN 46104198) is a randomised trial comparing prolonged Holter ECG monitoring (3x 10 day monitoring) and usual care in 400 patients with ischemic stroke. The primary results of Find-AF randomised will be submitted for presentation as a late breaking clinical trial to ISC 2016. In contrast to previous randomised trials (e. g. EMBRACE and CRYSTAL-AF), this trial will include all ischemic stroke patients, not only cryptogenic strokes. Hypothesis: We hypothesized that the AF detection rate is independent from the stroke subtype according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST), but is associated with clinical variables (e. g. age, NIHSS, prevalence of coronary artery disease). Methods: 402 patients with ischemic stroke were recruited on certified stroke units within seven days after the index event. Stroke was classified by the Trial of Org 10172 in Acute Stroke Treatment (TOAST), dividing the patient collective into five subgroups according to the most likely stroke etiology. Results: The following table presents a preliminary assessment of relevant baseline characteristics of 392 participants (full data set will be available upon abstract presentation. In addition, all index strokes will be independently assessed by an adjudication committee, consisting of three neurologists. We will present AF detection rates in different stroke subtypes. Conclusion: If our hypothesis is correct, future studies on AF detection in stroke patients should not be confined to stroke subtypes (e. g. cryptogenic or embolic stroke of unknown source), but rather include clinical parameters to increase the probability of finding AF.

Introduction: Undiagnosed atrial fibrillation (UAF) is a major burden in ischemic stroke. However, randomised trials have partly shown astonishingly low AF detection rates (e. g. in the CRYSTAL-AF study). This may be due to differences in baseline and stroke characteristics between studies. Hypothesis: We hypothesized that stroke patients in a randomised controlled trial have less severe strokes than patients in an observational trial with similar inclusion and exclusion criteria. Methods: We used data from the Find-AF observational (NCT 01855035) and the Find-AF randomised controlled trial (ISRCTN 46104198). We included only patients at study site Goettingen of the Find-AF randomised controlled trial (n=153) and only included patients from the Find-AF observational trial that fulfilled the inclusion/exclusion criteria of Find-AF randomised (n=90). We compared baseline characteristics of screened versus included patients in Find-AF randomised and baseline characteristics and stroke severity parameters between both studies. Data are shown as mean (Standard Deviation) or Median (25%; 75% percentile) and were compared by chi-square, t-test or Mann-Whitney U test. Results: Table 1 shows as comparison between baseline characteristics of both studies Comparing patients fulfilling the inclusion/exclusion criteria of Find-AF randomised, but unwilling to give informed consent to randomised patients showed a significant difference in age (77 ± 11 vs. 74 ± 8; p< 0.001), but no difference in gender (p=0.581). Conclusions: Both studies included patients similar in age, gender and many comorbidities. Major differences occurred in NIHSS and MRS. As NIHSS is a predictor of atrial fibrillation, randomized controlled trials investigating AF detection should include a minimum NIHSS to avoid a selection bias towards less severe strokes.