Yoshioka et al report a simple score for identifying a stroke patient who is at high risk for paroxysmal atrial fibrillation (PAF). The authors are from Tokyo Medical and Dental University, Yokohama City Minato Red Cross Hospital, and the National Disaster Medical Center in Japan.
iPAB = past history, atrial dilation, BNP
Patient selection: recent stroke
Parameters:
(1) past history of arrhythmia or antiarrhythmic drug use
(2) left atrial dilation (diameter in mm)
(3) serum BNP in pg/mL
Parameter
Finding
Points
history of arrhythmia or antiarrhythmia drug
no
0
yes
3
left atrial diameter
< 40 mm
0
>= 40 mm
1
BNP
< 50 pg/mL
0
50 to 89 pg/mL
1
90 to 149 pg/mL
2
>= 150 pg/mL
3
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• A score >= 2 has a sensitivity of 93% and specificity of 71% for atrial fibrillation.
• A score >= 4 has a sensitivity of 60% and specificity of 95%.
Performance:
• The area under the ROC curve is 0.93.
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