Abstract WMP109: Implementation of a Clinical Score for Predicting Atrial Fibrillation in Cryptogenic Stroke

Background: The HAVOC score was developed to predict the risk of atrial fibrillation (AF) in patients with embolic events of undetermined origin. The purpose of this study was to evaluate the utility of the HAVOC score to predict AF in patients with cryptogenic stroke, included in a secondary prevention program (PROTEGE-ACV). Methods: patients with cryptogenic stroke were included. HAVOC score (one point each for peripheral vascular disease and obesity with body mass index >30, two points each for hypertension, age > 75, valvular heart disease, and coronary artery disease, 4 points for congestive heart failure) was calculated for all patients. AF was tracked by serial cardiac holter during the first 3 years of follow-up. Results: from December 2006 to December 2018, 836 patients with cryptogenic stroke were included. Mean age was 75 ± 13 years and 54% were women. The AF was detected in 14% of patients in the first year, 30% in the second year and 35% in the third year. When patients without AF (n: 544) and patients with AF (N: 292) were compared, a higher prevalence of women (59% vs. 50%, P0.01) and heart failure (37% vs. 20%, P0.001) were observed in patients with AF. The HAVOC score was significantly higher among patients with AF [median 4 with interquartile range (IQR) 2-5] than those without AF [median 2.0 (IQR 0-3)], p = 0.01. In the follow-up, all patients with a baseline HAVOC score greater than 4 developed AF. Conclusions: The HAVOC score is a simple tool based on clinical data, that can be useful for determining a high-risk AF population among patients with cryptogenic stroke.