Embolic strokes of undetermined source: prevalence and patient features in the esus global registry
| Autor: | Perera, K. S., Vanassche, T., Bosch, J., Giruparajah, M., Swaminathan, B., Mattina, K. R., Berkowitz, S. D., Arauz, A., O'Donnell, M. J., Ameriso, S. F., Hankey, G. J., Yoon, B. -W., Lavallee, P., Cunha, L., Shamalov, N., Brouns, R., Gagliardi, R. J., Kasner, S. E., Pieroni, A., Vermehren, P., Kitagawa, K., Wang, Y., Muir, K., Coutinho, J., Vastagh, I., Connolly, S. J., Hart, R. G., Czeto, K., Kahn, M., Gomez Schneider, M., Pujol Lereis, V., Hawkes, M., Pertierra, L., Perera, N., De Smedt, A., Van Dyck, R., Van Hooff, R. J., Yperzeele, L., Baptista Gagliardi, V. D., Cerqueir, L. G., Yang, X., Chen, W., Amarenco, P., Guidoux, C., Ringleb, P. A., Bereczki, D., Canavan, M., Toni, D., Anzini, A., Colosimo, C., De Michele, M., Di Mascio, M. T., Durastanti, L., Falcou, A., Fausti, S., Mancini, A., Mizumo, S., Uchiyama, S., Kim, C. K., Jung, S., Kim, Y., Kim, J. A., J. Y., Jo, Barboza, M., Quiroz-Compean, A., Colin, J., Nederkoorn, P. J., Roxas, A., Perez Marianito, V., Santo, G., Silva, F., Sargento-Freitas, J., Coelho, J., Kustova, M., Meshkova, K., Williams, G., Siegler, J., Zhang, C., Gallatti, N., Kruszewski, M. |
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| Přispěvatelé: | Clinical sciences, Neuroprotection & Neuromodulation, ANS - Neurovascular Disorders, Neurology, ACS - Amsterdam Cardiovascular Sciences, ESUS Global Registry Investigators |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Internationality Cross-sectional study 030204 cardiovascular system & hematology stroke-etiology cerebral embolism embolism Atrial fibrillation Cerebral embolism Diagnostic evaluation Embolism Stroke Stroke-etiology Brain Ischemia 03 medical and health sciences ischemic-stroke 0302 clinical medicine Risk Factors Internal medicine medicine Prevalence Humans atrial fibrillation Registries cardiovascular diseases Aged Retrospective Studies Medicine(all) business.industry International survey Retrospective cohort study Mean age Middle Aged diagnostic evaluation medicine.disease stroke atrial-fibrillation Cross-Sectional Studies Neurology stroke—etiology Ischemic stroke Cardiology cryptogenic stroke Female Human medicine business 030217 neurology & neurosurgery |
| Zdroj: | International journal of stroke, 11(5), 526-533. SAGE Publications Ltd International Journal of Stroke |
| ISSN: | 1747-4949 1747-4930 |
| Popis: | Background Recent evidence supports that most non-lacunar cryptogenic strokes are embolic. Accordingly, these strokes have been designated as embolic strokes of undetermined source (ESUS). Aims We undertook an international survey to characterize the frequency and clinical features of ESUS patients across global regions. Methods Consecutive patients hospitalized for ischemic stroke were retrospectively surveyed from 19 stroke research centers in 19 different countries to collect patients meeting criteria for ESUS. Results Of 2144 patients with recent ischemic stroke, 351 (16%, 95% CI 15% to 18%) met ESUS criteria, similar across global regions (range 16% to 21%), and an additional 308 (14%) patients had incomplete evaluation required for ESUS diagnosis. The mean age of ESUS patients (62 years; SD = 15) was significantly lower than the 1793 non-ESUS ischemic stroke patients (68 years, p ≤ 0.001). Excluding patients with atrial fibrillation ( n = 590, mean age = 75 years), the mean age of the remaining 1203 non-ESUS ischemic stroke patients was 64 years ( p = 0.02 vs. ESUS patients). Among ESUS patients, hypertension, diabetes, and prior stroke were present in 64%, 25%, and 17%, respectively. Median NIHSS score was 4 (interquartile range 2–8). At discharge, 90% of ESUS patients received antiplatelet therapy and 7% received anticoagulation. Conclusions This cross-sectional global sample of patients with recent ischemic stroke shows that one-sixth met criteria for ESUS, with additional ESUS patients likely among those with incomplete diagnostic investigation. ESUS patients were relatively young with mild strokes. Antiplatelet therapy was the standard antithrombotic therapy for secondary stroke prevention in all global regions. |
| Databáze: | OpenAIRE |
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