Incidence and Predictors of Recurrent Stroke in Cryptogenic Stroke Patients With Atrial Fibrillation

NCT ID: NCT07126184

Last Updated: 2025-08-17

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 109 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2018-01-01
• Study Completion Date: 2023-12-31

Brief Summary

Brief Summary:

This study aimed to investigate the risk and factors that predict recurrent stroke in patients who initially had a stroke with no clear cause (called cryptogenic stroke) and were later found to have atrial fibrillation (AF), an irregular heart rhythm that can increase stroke risk. The study was conducted at Lady Reading Hospital in Peshawar, Pakistan, over five years from 2018 to 2023.

Stroke is a leading cause of death and disability worldwide. In many cases, the cause of stroke is unclear, which makes it difficult to prevent it from happening again. Atrial fibrillation is a common hidden cause of such strokes but is often hard to detect because it can occur intermittently without symptoms. Detecting AF early is important because patients with AF benefit greatly from blood-thinning medicines (anticoagulants) that reduce the risk of another stroke.

In this study, medical records of patients diagnosed with cryptogenic stroke were reviewed. Patients who were later diagnosed with atrial fibrillation within 12 months of their stroke were included. The researchers collected information about their age, gender, heart examinations, how and when AF was diagnosed, use of blood-thinning medicines, and if they had another stroke during follow-up.

The study highlights the importance of early and prolonged heart rhythm monitoring in patients with cryptogenic stroke to detect atrial fibrillation. It also stresses the need for better access to and adherence to anticoagulant therapy in resource-limited settings like Pakistan to reduce the risk of recurrent stroke and improve patient outcomes.

Conditions

Cryptogenic Stroke; Atrial Fibrillation; Recurrent Ischemic Stroke

Study Design

• Observational Model Type: OTHER
• Study Time Perspective: RETROSPECTIVE

Interventions

Extended Cardiac Monitoring

This observational study involved the use of standard cardiac monitoring methods to detect atrial fibrillation in patients initially diagnosed with cryptogenic ischemic stroke. Monitoring techniques included 12-lead ECG, 24-hour Holter monitoring, and implantable loop recorders (ILRs). No experimental interventions were assigned; patients received routine clinical care.

Intervention Type: DIAGNOSTIC_TEST

Eligibility Criteria

Inclusion Criteria

• Adults aged 18 years or older.
• Patients initially diagnosed with cryptogenic ischemic stroke confirmed by neuroimaging and standard diagnostic evaluation.
• Patients subsequently diagnosed with atrial fibrillation within 12 months of index stroke, confirmed by ECG, 24-hour Holter monitoring, or implantable loop recorder.
• Availability of complete clinical and follow-up data.

Exclusion Criteria

• Known history of atrial fibrillation or atrial flutter prior to the index stroke.
• Presence of structural heart diseases, valvular abnormalities, or congenital cardiac anomalies.
• Incomplete clinical or follow-up data.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Nangarhar University

OTHER

Sponsor Role: lead

Responsible Party

Rafiullah Hotak

Doctor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

LRH/MTI

Peshawar, KPK, Pakistan

Countries

Pakistan

Other Identifiers

Ref: No. 331/LRH/MTI

Identifier Type: -

Identifier Source: org_study_id