{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T05:20:21Z","timestamp":1764998421329,"version":"3.46.0"},"reference-count":20,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,6,18]]},"published-print":{"date-parts":[[2019,7]]},"abstract":"\n Objective<\/jats:title>\n We report on: (1) the proportion of patients with known atrial fibrillation (AF); and (2) demographic, clinical or radiological differences between patients with known AF (and not treated) and patients with newly diagnosed AF, in a cohort of patients who presented with ischaemic stroke or transient ischaemic attack (TIA) not previously treated with anticoagulation.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n We reviewed cross-sectional baseline demographic and clinical data from a prospective observational cohort study, (CROMIS-2).<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Patients were recruited from 79 hospital stroke centres throughout the UK and one centre in the Netherlands.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Patients were eligible if they were adults who presented with ischaemic stroke or TIA and AF and had not been previously treated with oral anticoagulation.<\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n \n Proportion of patients with known AF before index ischaemic stroke or TIA from a cohort of patients who have not been previously treated with oral anticoagulation. Secondary analysis includes the comparison of CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc and HAS-BLED scores and other demographics and risk factors between those with newly diagnosed AF and those with previously known AF.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 1470 patients included in the analysis (mean age 76 years (SD 10)), 622 (42%) were female; 999 (68%) patients had newly diagnosed AF and 471 (32%) patients had known AF. Of the 471 patients with known AF, 68% had a strong indication for anticoagulation and 89% should have been considered for anticoagulation based upon CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc score. Patients with known AF were more likely to have a prior history of dementia (4% vs 2%, p=0.02) and had higher HAS-BLED scores (median 3 vs 2). CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc, other risk factors and demographics were similar.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n About 1\/3 of patients who present with stroke and have AF who have not been treated with oral anticoagulation have previously known AF. Of these patients, at least 68% were not adequately treated with oral anticoagulation.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n NCT02513316<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-028387","type":"journal-article","created":{"date-parts":[[2019,7,25]],"date-time":"2019-07-25T07:34:09Z","timestamp":1564040049000},"page":"e028387","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Potential missed opportunities to prevent ischaemic stroke: prospective multicentre cohort study of atrial fibrillation-associated ischaemic stroke and TIA"],"prefix":"10.1136","volume":"9","clinical-trial-number":[{"clinical-trial-number":"nct02513316","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Duncan","family":"Wilson","sequence":"first","affiliation":[{"name":"New Zealand Brain Research Institute, Christchuch, New Zealand"},{"name":"Brain Repair and Rehabilitation, Institute of Neurology, UCL, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gareth","family":"Ambler","sequence":"additional","affiliation":[{"name":"Department of Statistical science, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare","family":"Shakeshaft","sequence":"additional","affiliation":[{"name":"Brain Repair and Rehabilitation, Institute of Neurology, UCL, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gargi","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Brain Repair and Rehabilitation, Institute of Neurology, UCL, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5891-337X","authenticated-orcid":false,"given":"Andreas","family":"Charidimou","sequence":"additional","affiliation":[{"name":"Stroke Research Group, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK"},{"name":"Department of Neurology, Hemorrhagic Stroke Research Program, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Seiffge","sequence":"additional","affiliation":[{"name":"Brain Repair and Rehabilitation, Institute of Neurology, UCL, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"White","sequence":"additional","affiliation":[{"name":"Brain Repair and Rehabilitation, Institute of Neurology, UCL, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Cohen","sequence":"additional","affiliation":[{"name":"Haemostasis Research Unit, Department of Haematology, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarek","family":"Yousry","sequence":"additional","affiliation":[{"name":"Lysholm Department of Neuroradiology, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Al-Shahi Salman","family":"Rustam","sequence":"additional","affiliation":[{"name":"Centre for clinical brain sciences, University of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory Y H","family":"Lip","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Muir","sequence":"additional","affiliation":[{"name":"University of Glasgow, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin M","family":"Brown","sequence":"additional","affiliation":[{"name":"Neurology, UCL, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H R","family":"J\u00e4ger","sequence":"additional","affiliation":[{"name":"Stroke Research Group, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J","family":"Werring","sequence":"additional","affiliation":[{"name":"Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, 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