Δημοσίευση στις 2019 Jun 15 στο PubMed: https://pubmed.ncbi.nlm.nih.gov/30986703/?from_term=tsioufis&from_sort=date&from_size=200&from_pos=38

 

Georgios Tsivgoulis 

, Odysseas Kargiotis 

, Aristeidis H Katsanos 

, Athanasia Patousi 

, Dimitris Mavridis 

, Sofia Tsokani 

, Maria Pikilidou 

, Theodosis Birbilis 

, Michael Mantatzis 

, Christina Zompola 

, Sokratis Triantafyllou 

, Nikolaos Papanas 
0
, Panagiotis Skendros 

, Aikaterini Terzoudi 

, George S Georgiadis 

, Efstratios Maltezos 
0
, Charitomeni Piperidou 

, Konstantinos Tsioufis 

, Ioannis Heliopoulos 

, Konstantinos Vadikolias 

Affiliations

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Georgios Tsivgoulis et al.


J Neurol Sci.

2019

Abstract

Embolic stroke of undetermined source (ESUS) represents a subgroup of cryptogenic ischemic stroke (CS) distinguished by high probability of an underlying embolic mechanism. There are scarce population-based data regarding the incidence, characteristics and outcomes of ESUS. Consecutive patients included with first-ever ischemic stroke of undetermined cause in the previously published population-based Evros Stroke Registry were further subdivided into ESUS and non-ESUS CS. Crude and adjusted [according to the European Standard Population (ESP), WHO and Segi population] incidence rates (IR) for ESUS and non-ESUS CS were calculated. Baseline characteristics, admission stroke severity (assessed using NIHSS-score), stroke recurrence and functional outcomes [determined by modified Rankin Scale (mRS) scores], were recorded during the 1-year follow-up period. We identified 21 and 242 cases with ESUS (8% of CS) and non-ESUS CS. The crude and ESP-adjusted IR for ESUS were 17.5 (95%CI: 10-25) and 16.6 (95%CI: 10-24) per 100,000 person-years. Patients with ESUS were younger (p < .001) and had lower median admission NIHSS-scores (p < .001). Functional outcomes were more favorable in ESUS at 28, 90 and 365 days. ESUS was independently (p = .033) associated with lower admission NIHSS-scores (unstandardized linear regression coefficient: -13.34;95%CI: -23.34, -3.35) on multiple linear regression models. ESUS was not related to 1-year stroke recurrence, mortality and functional improvement on multivariable analyses. In conclusion we found that ESUS cases represented 8% of CS patients in this population-based study. Despite the fact that ESUS was independently related to lower admission stroke severity, there was no association of ESUS with long-term outcomes.


Keywords:

Anticoagulation; Atrial fibrillation; Cryptogenic stroke; Embolic stroke of undetermined source; Incidence rate; Mortality; Population-based; Recurrence.

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