Abstract
The aim of this study was to evaluate the diagnostic value of the Score for the Targeting of Atrial Fibrillation (STAF) in combination with the serum D-dimer (DD) levels in cardioembolism(CE).This study was a retrospective case-onlystudy, consecutively including patients with acute ischemic stroke. All patients were evaluated following the STAF scoring criteria and were classified according to the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) etiology classification criteria. A total of 317 patients were enrolled, including 37 CE cases (11.67%). STAF ≥5 showed a sensitivity of 89% and a specificity of 91% for the diagnosis of CE, whereas DD >791.30 ng/mL had a sensitivity of 58% and a specificity of 78%. When the STAF was used in combination with the DD level, the sensitivity was 95%, and the specificity was 100%.STAF score is an excellent tool for the diagnosis of CE when combined with DD, and can facilitate the etiological classification of acute ischemic stroke.
Highlights
Ischemic stroke can be divided into two types according to their etiology: cardioembolism (CE) and non-cardioembolic stroke
To determine DD levels in the sera, 4 mL of fasting cubital venous blood was collected from each patient in the morning after the day they were admitted to the hospital, anticoagulated using sodium citrate, and centrifuged at 3000 r/min for 10 minutes for the isolation of Score for the Targeting of Atrial Fibrillation (STAF) score and D-dimer in cardioembolism serum
All patients were classified according to the TOAST etiology classification criteria [11] and divided into five types: large-artery atherosclerosis (LAA), cardioembolism (CE), small-arteryocclusion (SAA), stroke of other determined etiology (SOE), and stroke of undeterminedetiology (SUE)
Summary
Ischemic stroke can be divided into two types according to their etiology: cardioembolism (CE) and non-cardioembolic stroke. These two types of ischemic stroke have significantly different treatment regimens, especially in the choice of secondary prevention strategies. Early classification of acute ischemic stroke patients based on etiology facilitates the selection of appropriate secondary prevention strategies. CE has a lower diagnostic rate and a higher missed diagnosis rate in Chinese clinical practice than abroad. This disparity can largely be attributed to this dearth of targeted assessments. A reliable tool for the preliminary differential diagnosis of the etiological type is needed to guide further targeted testing and to determine the CE diagnosis, which will greatly improve the diagnostic rate of CE
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