Researchers at Western University hope their systematic review of almost 12,000 patients will raise awareness among physicians about the need for more extensive testing for atrial fibrillation, or heart rhythm disturbances, following a stroke or transient ischemic attack (TIA).
The review, published by Lancet Neurology, analyzed the results of 50 studies from four continents and showed that almost 24 per cent of stroke patients with no history of atrial fibrillation can be newly diagnosed with atrial fibrillation when using multiple cardiac monitoring methods sequentially. That’s more than twice higher than previous estimates which are based on only one or two methods of diagnosis.
“We found that by using a sequential combination of different cardiac monitoring methods, the number of ischemic stroke and TIA patients newly diagnosed with atrial fibrillation can be increased considerably,” said Dr. Luciano Sposato, a recently recruited Associate Professor of Neurology at Western’s Schulich School of Medicine & Dentistry and lead author on the study. “This is significant because detection of atrial fibrillation after stroke is crucial for preventing further strokes in these patients.”
The researchers estimated that, overall, almost four in 10 stroke and TIA patients can be diagnosed with atrial fibrillation when combining those diagnosed before and after the stroke. This has major clinical implications due to the fact that among patients with atrial fibrillation, the risk of recurrent stroke can be reduced by up to two thirds with the prescription of oral anticoagulant drugs.
“My hope is that physicians treating stroke patients will be more aware about the importance of pursuing more intensive cardiac monitoring for patients following stroke,” Sposato said. “This may have a direct impact on the number of patients diagnosed with atrial fibrillation and the number of stroke survivors receiving oral anticoagulants to prevent further strokes.”
Sposato co-authored the review with Dr. Vladimir Hachinski, Dr. Patricia Riccio and Estefania Ruiz Vargas in the Department of Clinical Neurological Sciences at Schulich Medicine & Dentistry, Lauren Cipriano from Western’s Ivey Business School and Dr. Gustavo Saposnik, a Neurologist at St. Michael’s Hospital in Toronto. Funding was provided by the Heart and Stroke Foundation of Canada, and the Natural Science and Engineering Research Council of Canada.
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