Les accidents vasculaires cérébraux chez les patients en fibrillation atriale: Prévalence et facteurs prédictifs

BACKGROUND: Silent strokes are damages of brain not accompanied by symptoms suggestive of stroke. Current epidemiological trends suggest their independent association with atrial fibrillation (AF). However, this association is not yet well defined. AIM: To assess the prevalence of silent stroke in AF and determine its predictive factors. METHODS: We carried out a cross-sectional study enrolling 37 patients followed for non-valvular AF in the cardiology department. All participants had a clinical evaluation and brain MRI. RESULTS: The mean age was 66 ± 7 years with asex ratio (M / F) of 0.76. The most common class of AF was the persistent form (70%). Oral anticoagulant therapy was prescribed in 32 patients (94.1%). Silent stroke were reported in 9 patients (24.3%). Age ≥72 years and CHA2DS2VASc score ≥ 4 were significantly associated with silent strokes in the univariate study with sensitivities of 77.8% and 62.5% respectively and specificities of 78.6% and 92.3% respectively. In the multivariate study, only CHA2DS2VASc score ≥ 4 was considered to be an independent predictor of silent stroke in AF (p = 0.004; adjusted OR = 20; CI95%: 2.6-152.6). CONCLUSIONS: Our results regarding the association between silent strokes and AF confirmed previous evidence. Screening for these lesions in AF patients at high thromboembolic risk appears to be a relevant approach given their poor prognosis.