ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2025
Comparative clinical profiles and outcomes of prior vs. concurrently diagnosed atrial fibrillation in acute ischaemic stroke: the implication of diagnosis timing.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Application of Artificial Intelligence in the Early Detection and Management of Atrial Fibrillation: State-of-the-art Review.European cardiology · 2026Review
- Characteristics and outcomes of previously known versus newly detected atrial fibrillation after ischemic stroke.BMC cardiovascular disorders · 2025Article
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9 authors.
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Abstract
aimsBased on the diagnostic sequence in relation to stroke, a recent classification of atrial fibrillation (AF) categorizes AF into known AF (KAF) and AF detected after stroke or transient ischaemic attack (AFDAS). However, relatively little is known about AF 'concurrently diagnosed with stroke'-perhaps the 'grey zone' of AF between KAF and AFDAS, which has been less characterized in terms of its resemblance to clinical characteristics and outcomes compared with AFDAS or KAF. METHODS AND
resultsPatients with AF who were admitted for acute ischaemic stroke (IS) in 2010-20 were retrospectively reviewed. Clinical characteristics and net clinical outcome (NCO)-the composite of recurrent stroke, major bleeding, hospitalization or emergency department visits for cardiovascular events, and death-were compared between AF diagnosed before stroke (prior AF) and incident AF diagnosed concurrently with IS (AFDCS). A total of 720 patients with AF and acute IS (mean age, 72.5 ± 10.1 years; 60.3% male) were included: prior AF, 62.6% (n = 451), and AFDCS, 37.4% (n = 269). Prior AF presented with more prevalent diabetes, heart failure, vascular disease, and valvular heart disease than AFDCS (all P < 0.05). The AFDCS had a significantly higher left ventricular ejection fraction and smaller left atrial diameter than prior AF. During a median follow-up of 2.0 (interquartile range 0.6-4.6) years, AFDCS was associated with a lower risk of NCO than prior AF without significant differences in the risk of recurrent stroke: adjusted hazard ratio (95% confidence interval), 0.776 (0.611-0.986), P = 0.038 for NCO and 0.784 (0.450-1.365), P = 0.389 for recurrent stroke.
conclusionPrior AF and AFDCS have distinctive clinical profiles supporting AF is a disease of continuum according to its diagnostic vicinity to the IS. In terms of recurrent IS, AFDCS has a comparable risk with prior AF, indicating the importance of early detection and integrated management of AF for patients with IS.
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