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Completed

NCT Number: NCT07126184

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

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.

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Key information

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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.

Treatment and study plan

Extended Cardiac Monitoring

Diagnostic Test

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.

Primary outcomes

  1. Incidence of Recurrent Ischemic Stroke

    Time frame: 5 years

    Occurrence of new ischemic stroke confirmed by clinical assessment and neuroimaging during the follow-up period in patients initially diagnosed with cryptogenic stroke and later diagnosed with atrial fibrillation.

Sponsors and collaborators

Lead sponsor

Nangarhar University

Other

Registry information

Official study title

Incidence and Predictors of Recurrent Stroke in Patients With Cryptogenic Stroke Later Diagnosed With Atrial Fibrillation: A 5-Year Study From Lady Reading Hospital, Peshawar

Important dates

Study start
2018
Primary completion
2023
Study completion
2023
First posted
Aug 17, 2025
Registry last updated
Aug 17, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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