The ABC‐Stroke Risk Score and Effects of Atrial Fibrillation Screening on Stroke Prevention: Results From the Randomized LOOP Study
Background The ABC‐stroke score is a risk scheme for prediction of stroke or systemic embolism (SE) in atrial fibrillation (AF). This study sought to examine whether the score could be useful in predicting stroke in AF‐naïve individuals and risk stratifying for AF screening. Methods and Results The...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.032744 |
| _version_ | 1826988123945435136 |
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| author | Lucas Yixi Xing Søren Zöga Diederichsen Søren Højberg Derk W. Krieger Claus Graff Ruth Frikke‐Schmidt Pyotr G. Platonov Morten S. Olesen Axel Brandes Lars Køber Ketil Jørgen Haugan Jesper Hastrup Svendsen |
| author_facet | Lucas Yixi Xing Søren Zöga Diederichsen Søren Højberg Derk W. Krieger Claus Graff Ruth Frikke‐Schmidt Pyotr G. Platonov Morten S. Olesen Axel Brandes Lars Køber Ketil Jørgen Haugan Jesper Hastrup Svendsen |
| author_sort | Lucas Yixi Xing |
| collection | DOAJ |
| description | Background The ABC‐stroke score is a risk scheme for prediction of stroke or systemic embolism (SE) in atrial fibrillation (AF). This study sought to examine whether the score could be useful in predicting stroke in AF‐naïve individuals and risk stratifying for AF screening. Methods and Results The LOOP (Atrial Fibrillation Detected by Continuous ECG Monitoring Using Implantable Loop Recorder to Prevent Stroke in High‐Risk Individuals) study randomized 6004 AF‐naïve individuals aged 70 to 90 years with stroke risk factors to either screening with an implantable loop recorder and anticoagulation upon detection of new‐onset AF episodes ≥6 minutes, or usual care. A total of 5781 participants had available ABC‐stroke score at baseline and were included in this secondary analysis: 4170 (72.1%) with an estimated stroke/SE risk ≤1%/year versus 1611 (27.9%) with an estimated stroke/SE risk >1%/year. Having an annual ABC‐stroke risk >1% was associated with stroke/SE, stroke/SE/cardiovascular death, and all‐cause death (hazard ratio, 1.82 [95% CI, 1.44–2.21], 2.17 [95% CI, 1.80–2.62], and 2.19 [95% CI, 1.87–2.56], respectively). For screening with implantable loop recorder versus usual care, no significant reduction in these study outcomes was obtained in any ABC‐stroke risk groups (P>0.0500 for all), with no signal toward interaction (Pinteraction>0.2500 for all). Similar findings were yielded when assessing the ABC‐stroke score as a continuous variable. Conclusions In an elderly, AF‐naïve population with additional stroke risk factors, a higher ABC‐stroke score could identify individuals with increased stroke risk. However, this risk score may not be useful in pinpointing those more likely to benefit from AF screening and subsequent preventive treatment. These findings should be considered as hypothesis generating and warrant further study. Registration URL: https://www.clinicaltrials.gov; unique identifier: NCT02036450. |
| first_indexed | 2024-03-07T23:33:11Z |
| format | Article |
| id | doaj.art-16b097f7cf2045e983390ff7f9f30d21 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2025-02-18T07:48:04Z |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-16b097f7cf2045e983390ff7f9f30d212024-11-05T14:15:41ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-02-0113410.1161/JAHA.123.032744The ABC‐Stroke Risk Score and Effects of Atrial Fibrillation Screening on Stroke Prevention: Results From the Randomized LOOP StudyLucas Yixi Xing0Søren Zöga Diederichsen1Søren Højberg2Derk W. Krieger3Claus Graff4Ruth Frikke‐Schmidt5Pyotr G. Platonov6Morten S. Olesen7Axel Brandes8Lars Køber9Ketil Jørgen Haugan10Jesper Hastrup Svendsen11Department of Cardiology Copenhagen University Hospital–Rigshospitalet Copenhagen DenmarkDepartment of Cardiology Copenhagen University Hospital–Rigshospitalet Copenhagen DenmarkDepartment of Cardiology Copenhagen University Hospital–Bispebjerg Copenhagen DenmarkDepartment of Neurology, Mediclinic City Hospital Dubai United Arabic EmiratesDepartment of Health Science and Technology Aalborg University Gistrup DenmarkDepartment of Clinical Biochemistry Copenhagen University Hospital–Rigshospitalet Copenhagen DenmarkSection II–Cardiology, Department of Clinical Sciences Lund University Lund SwedenDepartment of Cardiology Copenhagen University Hospital–Rigshospitalet Copenhagen DenmarkDepartment of Clinical Research, Faculty of Health Sciences University of Southern Denmark Odense DenmarkDepartment of Cardiology Copenhagen University Hospital–Rigshospitalet Copenhagen DenmarkDepartment of Cardiology Zealand University Hospital–Roskilde Roskilde DenmarkDepartment of Cardiology Copenhagen University Hospital–Rigshospitalet Copenhagen DenmarkBackground The ABC‐stroke score is a risk scheme for prediction of stroke or systemic embolism (SE) in atrial fibrillation (AF). This study sought to examine whether the score could be useful in predicting stroke in AF‐naïve individuals and risk stratifying for AF screening. Methods and Results The LOOP (Atrial Fibrillation Detected by Continuous ECG Monitoring Using Implantable Loop Recorder to Prevent Stroke in High‐Risk Individuals) study randomized 6004 AF‐naïve individuals aged 70 to 90 years with stroke risk factors to either screening with an implantable loop recorder and anticoagulation upon detection of new‐onset AF episodes ≥6 minutes, or usual care. A total of 5781 participants had available ABC‐stroke score at baseline and were included in this secondary analysis: 4170 (72.1%) with an estimated stroke/SE risk ≤1%/year versus 1611 (27.9%) with an estimated stroke/SE risk >1%/year. Having an annual ABC‐stroke risk >1% was associated with stroke/SE, stroke/SE/cardiovascular death, and all‐cause death (hazard ratio, 1.82 [95% CI, 1.44–2.21], 2.17 [95% CI, 1.80–2.62], and 2.19 [95% CI, 1.87–2.56], respectively). For screening with implantable loop recorder versus usual care, no significant reduction in these study outcomes was obtained in any ABC‐stroke risk groups (P>0.0500 for all), with no signal toward interaction (Pinteraction>0.2500 for all). Similar findings were yielded when assessing the ABC‐stroke score as a continuous variable. Conclusions In an elderly, AF‐naïve population with additional stroke risk factors, a higher ABC‐stroke score could identify individuals with increased stroke risk. However, this risk score may not be useful in pinpointing those more likely to benefit from AF screening and subsequent preventive treatment. These findings should be considered as hypothesis generating and warrant further study. Registration URL: https://www.clinicaltrials.gov; unique identifier: NCT02036450.https://www.ahajournals.org/doi/10.1161/JAHA.123.032744atrial fibrillationcardiac biomarkerrisk scorescreeningstroke |
| spellingShingle | Lucas Yixi Xing Søren Zöga Diederichsen Søren Højberg Derk W. Krieger Claus Graff Ruth Frikke‐Schmidt Pyotr G. Platonov Morten S. Olesen Axel Brandes Lars Køber Ketil Jørgen Haugan Jesper Hastrup Svendsen The ABC‐Stroke Risk Score and Effects of Atrial Fibrillation Screening on Stroke Prevention: Results From the Randomized LOOP Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atrial fibrillation cardiac biomarker risk score screening stroke |
| title | The ABC‐Stroke Risk Score and Effects of Atrial Fibrillation Screening on Stroke Prevention: Results From the Randomized LOOP Study |
| title_full | The ABC‐Stroke Risk Score and Effects of Atrial Fibrillation Screening on Stroke Prevention: Results From the Randomized LOOP Study |
| title_fullStr | The ABC‐Stroke Risk Score and Effects of Atrial Fibrillation Screening on Stroke Prevention: Results From the Randomized LOOP Study |
| title_full_unstemmed | The ABC‐Stroke Risk Score and Effects of Atrial Fibrillation Screening on Stroke Prevention: Results From the Randomized LOOP Study |
| title_short | The ABC‐Stroke Risk Score and Effects of Atrial Fibrillation Screening on Stroke Prevention: Results From the Randomized LOOP Study |
| title_sort | abc stroke risk score and effects of atrial fibrillation screening on stroke prevention results from the randomized loop study |
| topic | atrial fibrillation cardiac biomarker risk score screening stroke |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.032744 |
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