Incidence and nationwide estimates of cryptogenic ischemic stroke or TIA eligible for prolonged cardiac rhythm monitoring.

IF 5.8 3区医学 Q1 CLINICAL NEUROLOGY European Stroke Journal Pub Date : 2024-08-07 DOI:10.1177/23969873241266471

Yannick Béjot, Gauthier Duloquin, Charles Guenancia

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Abstract

Introduction: Current guidelines indicate prolonged cardiac rhythm monitoring for atrial fibrillation screening in patients with cryptogenic ischemic stroke (IS) or transient ischemic attack (TIA). This study aimed to assess the incidence of cryptogenic IS/TIA eligible for such investigation, and to estimate the number of patients potentially concerned in whole France annually.

Methods: All cryptogenic acute IS/TIA cases ⩾35 years old were retrieved from the population-based Dijon Stroke Registry, France (2013-2020). Patients eligible for prolonged cardiac rhythm monitoring were defined after excluding those who died in-hospital or within the first 30 days, or with preexisting major impairment. Annual incidence rates of eligible cryptogenic IS/TIA were calculated by age groups and sex. The total number of eligible patients in France was estimated by standardization to age- and sex-specific incidence.

Results: Among 2811 IS/TIA patients recorded in the Dijon Stroke Registry, 1239 had cryptogenic IS/TIA of whom 1045 were eligible for prolonged cardiac rhythm monitoring (517 IS and 528 TIA, mean age 73.6 ± 14.6 years old, 55.4% women). Crude incidence rates of eligible cryptogenic IS/TIA were 169/100,000 per year (95% CI: 159-179) in overall sexes, 83/100,000 per year (95% CI: 76-91) for IS, and 85/100,000 per year (95% CI: 78-93) for TIA. The total number of patients with cryptogenic IS/TIA eligible for prolonged cardiac rhythm monitoring in France was estimated to be 66,125 (95% CI: 65,622-66,630) for the calendar year 2022, including 32,764 (95% CI: 32,410-33,120) with IS and 33,361 (95% CI: 33,004-33,721) with TIA.

Conclusions: This study demonstrated a high incidence of cryptogenic IS/TIA eligible for prolonged cardiac rhythm monitoring. Estimates at a national level pointed out the large number of patients who may require access to such atrial fibrillation screening, with attention to be paid on regarding organization of care networks and related costs.

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符合长期心律监测条件的隐源性缺血性中风或 TIA 的发病率和全国估计值。

导言：现行指南指出，对隐源性缺血性中风（IS）或短暂性脑缺血发作（TIA）患者进行长期心律监测以筛查心房颤动。本研究旨在评估符合此类检查条件的隐源性 IS/TIA 的发病率，并估算全法国每年可能相关的患者人数：所有年龄在 35 岁以下的隐源性急性 IS/TIA 病例均来自法国第戎卒中人口登记处（2013-2020 年）。符合长期心律监测条件的患者是在排除了院内死亡或在最初 30 天内死亡的患者，或已存在严重功能障碍的患者后确定的。符合条件的隐源性IS/TIA年发病率按年龄组和性别进行计算。根据不同年龄和性别的发病率进行标准化，估算出法国符合条件的患者总数：结果：第戎卒中登记处记录的2811例IS/TIA患者中，有1239例患有隐源性IS/TIA，其中1045例符合长期心律监测条件（517例IS和528例TIA，平均年龄（73.6±14.6）岁，55.4%为女性）。符合条件的隐源性 IS/TIA 的粗发病率为：男女总发病率为每年 169 次/100,000 人（95% CI：159-179），IS 为每年 83 次/100,000 人（95% CI：76-91），TIA 为每年 85 次/100,000 人（95% CI：78-93）。据估计，2022日历年法国符合长期心律监测条件的隐源性IS/TIA患者总数为66,125人（95% CI：65,622-66,630），其中IS患者32,764人（95% CI：32,410-33,120），TIA患者33,361人（95% CI：33,004-33,721）：这项研究表明，符合长期心律监测条件的隐源性 IS/TIA 发生率很高。全国范围内的估算结果表明，可能有大量患者需要接受此类心房颤动筛查，因此需要关注医疗网络的组织和相关成本。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Stroke Journal Multiple-

CiteScore

7.50

自引率

6.60%

发文量

102

期刊介绍： Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.