Score for the Targeting of Atrial Fibrillation (STAF) A New Approach to the Detection of Atrial Fibrillation in the Secondary Prevention of Ischemic Stroke

Background and Purpose-The high risk of recurrence and comorbidity after a stroke associated with atrial fibrillation (AF) justifies an aggressive diagnostic approach so that anticoagulant treatment can be initiated. Methods-The clinical and paraclinical characteristics of consecutive ischemic stroke patients with and without documented AF were recorded. Independent predictive factors were then used to produce a predictive grading score for diagnosing AF, derived by logistic regression analysis: Score for the Targeting of Atrial Fibrillation (STAF). Results-STAF, calculated from the sum of the points for the 4 items (possible total score 0 to 8): age >62 years (2 points); NIHSS >= 8 (1 point); left atrial dilatation (2 points); absence of symptomatic intraor extracranial stenosis >= 50%, or clinico-radiological lacunar syndrome (3 points). STAF >= 5 identified patients with AF with a sensitivity of 89% and a specificity of 88%. Conclusions-STAF can be used as part of a novel and simple strategy for the targeting of AF in the secondary prevention of ischemic stroke. A multicenter study is now required to validate STAF in a larger number of patients. (Stroke. 2009; 40: 2866-2868.)