Four factors predict heart condition that causes strokes


A new way of detecting a common heart condition that increases the risk of a stroke has been developed.

While not life-threatening, an irregular heartbeat – known as ‘atrial fibrillation’ – raises the chances of suffering a stroke by up to five times.  Now researchers at the University of East Anglia (UEA) have identified four specific factors that can predict which patients will have atrial fibrillation.

These include older age, higher diastolic blood pressure and problems with both the coordination and function of the upper left chamber of the heart. 

The UEA team has created a simple tool for doctors to use in practice to identify those at high risk. They hope it will help diagnose and treat more patients, reducing their risk of future strokes.

Lead researcher Professor Vassilios Vassiliou, of UEA’s Norwich Medical School, 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 researchers 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. The team 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.”

Prof Vassiliou, Honorary Consultant Cardiologist at the Norfolk and Norwich University Hospital, added: “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.”

The study was published in the European Journal of Preventive Cardiology, and presented at the European Society of Cardiology Congress in Amsterdam.

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