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
Item in Clipboard
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.
Copyright © 2019. Published by Elsevier B.V.
Similar articles
-
Clinical and Neuroimaging Characteristics in Embolic Stroke of Undetermined versus Cardioembolic Origin: A Population-Based Study.
J Neuroimaging. 2019 Nov;29(6):737-742. doi: 10.1111/jon.12660. Epub 2019 Aug 28.
J Neuroimaging. 2019.
PMID: 31463999 -
Characteristics and outcomes of Embolic Stroke of Undetermined Source according to stroke severity.
Int J Stroke. 2020 Mar 2:1747493020909546. doi: 10.1177/1747493020909546. Online ahead of print.
Int J Stroke. 2020.
PMID: 32122289 -
Comparison of Functional Outcome and Stroke Recurrence in Patients with Embolic Stroke of Undetermined Source (ESUS) vs. Cardioembolic Stroke Patients.
PLoS One. 2016 Nov 10;11(11):e0166091. doi: 10.1371/journal.pone.0166091. eCollection 2016.
PLoS One. 2016.
PMID: 27832136
Free PMC article. -
Embolic Stroke of Undetermined Source: JACC Review Topic of the Week.
J Am Coll Cardiol. 2020 Jan 28;75(3):333-340. doi: 10.1016/j.jacc.2019.11.024.
J Am Coll Cardiol. 2020.
PMID: 31976872Review..
-
Cryptogenic Stroke: Diagnostic Workup and Management.
Curr Treat Options Cardiovasc Med. 2019 Dec 3;21(11):77. doi: 10.1007/s11936-019-0786-4.
Curr Treat Options Cardiovasc Med. 2019.
PMID: 31792625Review..
Cited by
2
PubMed Central articles
-
Active Cancer and Elevated D-Dimer Are Risk Factors for In-Hospital Ischemic Stroke.
Cerebrovasc Dis Extra. 2019 Nov 22;9(3):129-138. doi: 10.1159/000504163. Online ahead of print.
Cerebrovasc Dis Extra. 2019.
PMID: 31760390
Free PMC article. -
Potential Utility of Neurosonology in Paroxysmal Atrial Fibrillation Detection in Patients with Cryptogenic Stroke.
J Clin Med. 2019 Nov 16;8(11):2002. doi: 10.3390/jcm8112002.
J Clin Med. 2019.
PMID: 31744102
Free PMC article.