Characteristics of patients with cryptogenic stroke and atrial fibrillation detected using insertable cardiac monitoring in the chronic phase: a subanalysis of the LOOK study - Summary - MDSpire
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Characteristics of patients with cryptogenic stroke and atrial fibrillation detected using insertable cardiac monitoring in the chronic phase: a subanalysis of the LOOK study
To investigate the clinical characteristics of patients with late-detected atrial fibrillation (AF) identified more than 30 days after the onset of cryptogenic stroke (CS), compared to those without AF detection, specifically focusing on differences in age, risk factors, and clinical outcomes.
Key Findings:
AF was detected in 32.8% of patients, with 34 in the Late-detected AF group.
Late-detected AF patients were older (median age 78 vs. 66 years, p < 0.001) and had lower hyperlipidemia rates (17.6% vs. 39.5%, p = 0.03).
Higher rates of large-vessel occlusion were observed in the Late-detected AF group (26.5% vs. 10.5%, p = 0.01).
D-dimer levels were higher in the Late-detected AF group (1.1 vs. 0.7 μg/mL, p = 0.04).
Modified Rankin Scale scores before ICM implantation were lower in the Late-detected AF group compared to the Early-detected AF group (p = 0.05).
Interpretation:
Patients with late-detected AF after CS are typically older, have fewer atherosclerotic risk factors, and more frequently present with large-vessel occlusion, indicating a need for long-term rhythm monitoring in this population to improve post-stroke care.
Limitations:
The study is a subanalysis and may not capture all relevant clinical characteristics, potentially affecting the comprehensiveness of the findings.
Findings are based on a specific cohort from the LOOK study, which may limit generalizability to broader populations.
Conclusion:
Long-term rhythm monitoring is crucial for identifying late-detected AF in patients with cryptogenic stroke, particularly in older individuals with specific clinical profiles, to enhance secondary prevention strategies.
