Insertable cardiac monitoring after cryptogenic stroke in women was not associated with worse functional disability at 3 months compared to standard care (OR 0.77; 95% CI 0.50-1.20; p=0.22).
Cohort (n=475)
Yes
Does early insertable cardiac monitoring worsen functional disability or quality of life in women after cryptogenic stroke?
Early insertable cardiac monitoring after cryptogenic stroke in women does not worsen functional disability or quality of life at 3 months, supporting its patient acceptability.
Effect estimate: OR 0.77 (95% CI 0.50-1.20)
p-value: p=0.22
Abstract Background and aims Insertable cardiac monitors (ICMs) improve detection of atrial fibrillation after cryptogenic stroke but represent an invasive procedure. Patient-reported outcomes after ICM are limited. We investigated functional disability and patient-reported outcomes in women undergoing ICM after cryptogenic stroke. Methods We recruited patients with acute cryptogenic stroke at two university hospitals with different diagnostic strategies (2016–2023). At one centre, patients received ICM while the other centre followed standard care without ICM (control group). Functional outcome at 3 months was assessed by the modified Rankin Scale (mRS) and adjusted ordinal regression. Health-related quality of life at 3 months measured by EQ-5D-5L domains and EQ-VAS (EuroQol-5 Dimensions Visual Analogue Scale), available from 2019 onwards. Results Among 475 women with cryptogenic stroke (mean age 73 ± 12 years), 262 received ICM (median 4 days after stroke), and 3-month mRS was available in 82% of the total cohort. There was no significant difference in functional disability between groups (OR 0.77, 95% CI 0.50–1.20, p = 0.22). Age independently predicted poorer outcome. EQ-5D data were available for 169 women in the ICM group and 95 controls. EQ-VAS scores were similar between groups (median 75 in both), mostly reporting none/mild symptoms across EQ-5D domains. Importantly, women undergoing ICM did not report higher levels of pain or anxiety. Conclusions ICM after cryptogenic stroke in women was not associated with worse functional disability or impaired quality of life at 3 months. These findings support the safety and patient acceptability of invasive rhythm monitoring. Conflict of interest Jannicke Koldéus-Falch; nothing to disclose.
Koldéus-Falch et al. (Fri,) conducted a cohort in cryptogenic stroke (n=475). Insertable cardiac monitors (ICM) vs. Standard care without ICM was evaluated on Functional disability at 3 months assessed by modified Rankin Scale (mRS) (OR 0.77, 95% CI 0.50-1.20, p=0.22). Insertable cardiac monitoring after cryptogenic stroke in women was not associated with worse functional disability at 3 months compared to standard care (OR 0.77; 95% CI 0.50-1.20; p=0.22).