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. 2025 Jun 26;7(1):45.
doi: 10.1186/s42466-025-00399-8.

Baseline characteristics of patients with acute ischaemic stroke included in the randomised controlled Find-AF 2 trial

Katrin Wasser  1 , Tobias Uhe  2 , Wolf-Rüdiger Schäbitz  3 , Martin Köhrmann  4 , Martin Dichgans  5   6   7 , Johannes Brachmann  8 , Ulrich Laufs  2 , Götz Gelbrich  9   10 , David Petroff  11 , Christiane Prettin  11 , Dominik Michalski  12 , Johann Pelz  12 , Andrea Kraft  13 , Thorleif Etgen  14 , Hassan Soda  15 , Florian Bethke  16 , Peter D Schellinger  17 , Katharina Althaus  18 , Gerhard F Hamann  19 , Martin Grond  20 , Bernd Kallmünzer  21 , Martina Petersen  22 , Lars-Peder Pallesen  23 , Michael Ertl  19   24 , Philipp Zickler  24 , Sven Poli  25 , Karl Georg Haeusler  18   26 , Thorsten Steiner  27 , Paul Sparenberg  28 , Pawel Kermer  29 , Anna Kopczak  5 , Lars Kellert  30 , Martin Nückel  31 , Jan Liman  31 , Peter Arthur Ringleb  32 , Meinhard Mende  11 , Marcus Wagner  11   33 , Deborah Bochert  1 , Marlena Schnieder  1 , Imke Amanzada  1 , Sonja Gröschel  34 , Marianne Hahn  34 , Timo Uphaus  34 , Klaus Gröschel  34 , Rolf Wachter  35   36   37 ; Find-AF 2 study group
Collaborators, Affiliations

Baseline characteristics of patients with acute ischaemic stroke included in the randomised controlled Find-AF 2 trial

Katrin Wasser et al. Neurol Res Pract. .

Abstract

Background: In the Find-AF 2 randomised controlled trial, we investigate whether a risk-adapted intensified heart rhythm monitoring with subsequent initiation of oral anticoagulation in ischaemic stroke patients leads to a reduction of recurrent ischaemic stroke and systemic embolism. The objective of this analysis is to present baseline characteristics of the overall Find-AF 2 study population and stratified by low or high risk for developing AF.

Methods: The Find-AF 2 trial included acute ischaemic stroke patients ≥ 60 years of age within 30 days of ischaemic stroke of any cause. Before randomisation, patients received a 24-h Holter-ECG to exclude those with easily detectable AF and to determine the presence or absence of enhanced supraventricular ectopic activity (ESVEA), used as a marker indicating high or low risk for developing AF. Those without AF were randomly assigned 1:1 to either usual care diagnostics for AF detection (control group) or enhanced, prolonged and intensified ECG monitoring (intervention group). In the intervention group, patients with ESVEA received an implantable cardiac monitor (ICM), whereas those without ESVEA received repeated annual 7-day Holter ECGs. We present baseline characteristics of the overall Find-AF 2 population and stratified by ESVEA.

Results: Between July 2020 and July 2024, 5227 patients (mean age 72.3 ± 7.5 years, 40% female, 2618 intervention group, 2609 control group) were randomised from 52 study centres in Germany within a median of 5 (IQR 3-7) days after the index stroke. The most frequent stroke aetiologies were cryptogenic (60%) and small vessel occlusion (19%). 1152 (22%) patients were at high risk for developing AF and 4075 (78%) at low risk. Patients within the high-risk stratum were significantly older (mean age 75.2 versus 71.5 years, p < 0.001), more often had moderate to severe stroke (34% versus 30%, p < 0.001), non-lacunar (70% versus 64%, p < 0.001) and of cryptogenic aetiology (64% vs 58%, p < 0.001).

Conclusions: The Find-AF 2 trial has successfully completed recruitment of a large acute ischaemic stroke population with different stroke subtypes. The follow-up is ongoing and results are expected within two years.

Trial registration: ClinicalTrials.gov, Identifier NCT04371055, registered 24 April 2020.

Keywords: Atrial fibrillation; ECG monitoring; Randomised trial; Stroke.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The Find-AF 2 study was approved by the responsible ethics committee Leipzig (01.04.2020), in accordance with GCP ICH guidelines and the ethical standards laid down of 1964 Declaration of Helsinki. Only patients with a signed informed consent were included. Consent for publication: Not applicable. No data related to individual persons will be published. Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
CONSORT participant flow diagram at recruitment
Fig. 2
Fig. 2
Baseline characteristics in comparison to other ischaemic stroke populations. See Fig. 1 for a comparison between baseline data in Find-AF 2 and other ischaemic stroke trials. The trials depicted are Find-AF 2 [25], Find-AFrando [6], EMBRACE [4], MonDAFIS [9], CRYSTAL AF [5], PER DIEM [7], Stroke-AF [8], NAVIGATE ESUS [14], RE-SPECT ESUS [15], ATTICUS [16], and ARCADIA [17]. The vertical dashed lines represent the weighted mean over all the trials (weights according to patient numbers)
See this image and copyright information in PMC

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