Is Stroke risk analysis (SRA) a reliable method for predicting atrial fibrillation? A systematic review.

Autor: Gomes RAF; University of Pernambuco, Recife, Pernambuco, Brazil., Sá MPBO; University of Pernambuco, Recife, Pernambuco, Brazil., Montenegro MV; University of Pernambuco, Recife, Pernambuco, Brazil., Furtado LCC; University of Pernambuco, Recife, Pernambuco, Brazil., Costa JHCFD; University of Pernambuco, Recife, Pernambuco, Brazil., Coutinho DB; University of Pernambuco, Recife, Pernambuco, Brazil., Silva JHV; University of Pernambuco, Recife, Pernambuco, Brazil., Sobral Filho DC; University of Pernambuco, Recife, Pernambuco, Brazil.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Jun 25; Vol. 19 (6), pp. e0305339. Date of Electronic Publication: 2024 Jun 25 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0305339
Abstrakt: Introduction: Atrial fibrillation is responsible for a considerable number of cases of cardioembolism, accounting for 17% to 30% of the etiologies of all strokes. The software known as Stroke Risk Analysis (SRA) detects patients at high risk of paroxysmal atrial fibrillation by analyzing a continuous electrocardiogram recorded over different periods of time.
Objectives: This article aims to carry out a systematic review investigating the effectiveness of the SRA method in predicting the risk of stroke patients having paroxysmal atrial fibrillation as the cause of the event.
Methods: The methods correspond to the format of the International Prospective Register of Systematic Reviews Protocol, according to CRD Identification Code: CRD42021253974. A systematic search was carried out in BMJB, PubMed/MEDLINE, Science Direct and LILACS. Six cohort studies met the inclusion criteria, representing a total of 2,088 participants with stroke, and compared the detection of patients with paroxysmal atrial fibrillation on the continuous recording electrocardiogram with a time variation of 1 to 48h with the use of SRA.
Results: Studies have shown that SRA has a high negative predictive value (between 96 and 99.1%) and can contribute to the selection of patients at high risk of paroxysmal atrial fibrillation to be referred for implantable cardiac monitoring to continue the investigation.
Conclusions: A sequential combination of SRA with implantable cardiac monitoring is a promising strategy for detecting undiagnosed paroxysmal atrial fibrillation. Thus, the SRA can act as a cost-effective pre-selection tool to identify patients at higher risk of having paroxysmal atrial fibrillation as a possible cause of stroke and who may benefit from implantable cardiac monitoring. However, the lack of randomized studies is a limitation that must be considered.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Gomes et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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