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New tool created to reduce stroke risk

Researchers devise model to better identify those at risk of atrial fibrillation

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A new tool has been developed to help reduce stroke risk by identifying patients at risk of atrial fibrillation. 

Four specific factors have been highlighted which can predict which patients will have atrial fibrillation, a condition which increases the risk of transient ischaemic attack (TIA) or stroke by up to five times.

The factors, identified by researchers at the University of East Anglia, include older age, higher diastolic blood pressure and problems with both the coordination and function of the upper left chamber of the heart.

The team went on to create an easy tool for doctors to use in practice to identify those at high risk, which they hope will help in the diagnosis and treatment of more patients, reducing their risk of future strokes.

Lead researcher Professor Vassilios Vassiliou, from UEA’s Norwich Medical School and Honorary Consultant Cardiologist at the Norfolk and Norwich University Hospital, said: “Identifying who is at high risk and more likely to develop atrial fibrillation is very important.

“This is because it requires specific treatment with anticoagulants, commonly known as blood thinners, to reduce the risk of future strokes.

“Patients who have had a stroke usually undergo multiple investigations to determine the cause of the stroke, as this can influence the treatment they receive long-term.

“These investigations include prolonged monitoring of the heart rhythm with a small implantable device called a loop recorder, and an ultrasound of the heart, called an echocardiogram.”

The research team collected data from 323 patients across the East of England, treated at Cambridge University Hospitals NHS Foundation Trust, who had had a stroke with no cause identified – known as Embolic Stroke of Undetermined Source.

They analysed medical records as well as data from prolonged heart rhythm monitoring. They also studied their echocardiograms.

Prof Vassiliou said: “We determined how many of these patients were found to have atrial fibrillation up to three years following their stroke, and went on to perform a thorough assessment to identify if there are specific parameters that are connected with atrial fibrillation identification.

“We identified four parameters that were linked with the development of atrial fibrillation, which were consistently present in patients that had this arrhythmia.

“We then developed a model that can be used to predict who will show atrial fibrillation in the next three years, and is therefore at increased risk of another stroke in the future.

“This is a very easy tool that any doctor can use in clinical practice.

“And it can potentially help doctors provide more targeted and effective treatment to these patients, ultimately aiming to highlight the people at higher risk of this arrhythmia that can benefit from prolonged heart rhythm monitoring and earlier anticoagulation to prevent a future stroke.”

This research was led by the University of East Anglia in collaboration with Cambridge University Hospitals NHS Foundation Trust, West Suffolk Hospital NHS Foundation Trust, the University of Cambridge, the Norfolk and Norwich University Hospital and the University of Newcastle.

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