INTRODUCTION: Undetermined strokes with an embolic pattern (USEP) represent a common phenotype. We assessed their frequency and compared USEP with cardioembolic stroke with a known source and non-cardioembolic stroke etiology. METHODS: Study patients were 540 consecutive ischemic stroke patients admitted to Helsinki University Hospital with primary end-point of recurrent stroke in a 21-month follow-up. Cox regression adjusting for CHA2DS2-VASc and anticoagulation estimated the risk of USEP on recurrent stroke. RESULTS: A total of 229 (42.4%) patients had a non-cardioembolic stroke etiology, 184 (34.1%) had a cardioembolic stroke with a known source, and 127 (23.5%) were classified as USEP. USEP patients had less diabetes and prior TIA, with more severe symptoms than the non-cardioembolic stroke cases. They were younger, had fewer comorbidities, and less severe symptoms than the cardioembolic stroke patients. Cumulative risk of recurrent stroke was 10.0% (95% CI 4.1%-15.9%) for USEP, 5.0% (1.1%-8.9%) for cardioembolic strokes, and 5.0% (3.0%-7.0%) for non- cardioembolic strokes (P = 0.089). USEP associated with a higher risk of recurrent stroke compared to non-cardioembolic strokes (hazard ratio 2.36, 95% CI 1.02-5.47; P = 0.046) and cardioembolic stroke with a known source (1.83, 1.07-3.14; P = 0.028). CONCLUSIONS: Despite their younger age and more favorable risk factor profile compared with other phenotypes, USEP exhibited a high risk of stroke recurrence.
INTRODUCTION: Undetermined strokes with an embolic pattern (USEP) represent a common phenotype. We assessed their frequency and compared USEP with cardioembolic stroke with a known source and non-cardioembolic stroke etiology. METHODS: Study patients were 540 consecutive ischemic strokepatients admitted to Helsinki University Hospital with primary end-point of recurrent stroke in a 21-month follow-up. Cox regression adjusting for CHA2DS2-VASc and anticoagulation estimated the risk of USEP on recurrent stroke. RESULTS: A total of 229 (42.4%) patients had a non-cardioembolic stroke etiology, 184 (34.1%) had a cardioembolic stroke with a known source, and 127 (23.5%) were classified as USEP. USEP patients had less diabetes and prior TIA, with more severe symptoms than the non-cardioembolic stroke cases. They were younger, had fewer comorbidities, and less severe symptoms than the cardioembolic strokepatients. Cumulative risk of recurrent stroke was 10.0% (95% CI 4.1%-15.9%) for USEP, 5.0% (1.1%-8.9%) for cardioembolic strokes, and 5.0% (3.0%-7.0%) for non- cardioembolic strokes (P = 0.089). USEP associated with a higher risk of recurrent stroke compared to non-cardioembolic strokes (hazard ratio 2.36, 95% CI 1.02-5.47; P = 0.046) and cardioembolic stroke with a known source (1.83, 1.07-3.14; P = 0.028). CONCLUSIONS: Despite their younger age and more favorable risk factor profile compared with other phenotypes, USEP exhibited a high risk of stroke recurrence.
Authors: Tuomas Jussi Lumikari; Jani Pirinen; Jukka Putaala; Gerli Sibolt; Anne Kerola; Sami Pakarinen; Mika Lehto; Tuomo Nieminen Journal: Ann Noninvasive Electrocardiol Date: 2020-09-27 Impact factor: 1.468
Authors: Hisaki Makimoto; Muhammed Kurt; Michael Gliem; John-Ih Lee; Jan Schmidt; Patrick Müller; Lukas Clasen; Christoph Brinkmeyer; Dong-In Shin; Sebastian Jander; Malte Kelm; Alexander Fürnkranz Journal: J Am Heart Assoc Date: 2017-11-29 Impact factor: 5.501
Authors: Tuomas J Lumikari; Jukka Putaala; Anne Kerola; Gerli Sibolt; Jani Pirinen; Sami Pakarinen; Mika Lehto; Tuomo Nieminen Journal: Ann Noninvasive Electrocardiol Date: 2019-05-02 Impact factor: 1.468
Authors: Ali M Al Khathaami; Bayan Al Bdah; Abdulmjeed Alnosair; Abdulkarim Alturki; Rayan Alrebdi; Shorug Alwayili; Sulaiman Alhamzah; Fahad A M AlKhathaami; Nasser Alotaibi Journal: Stroke Res Treat Date: 2019-12-03