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Frequency and significance of cardiac sources of embolism in the TOAST classification

Sang Won Han1, Hyo Suk Nam, Seo Hyun Kim

  • 1Department of Neurology, Sanggyepaik Hospital, Inje University College of Medicine, Seoul, Korea.

Cerebrovascular Diseases (Basel, Switzerland)
|September 20, 2007
PubMed

Insights

High-risk cardiac sources of embolism, like atrial fibrillation, are strongly linked to cardioembolic stroke. Medium-risk sources, such as patent foramen ovale, were less frequently associated with cardioembolic stroke.

Area of Science:

  • Neurology
  • Cardiology
  • Stroke Medicine

Background:

  • Determining the frequency and patterns of cardiac sources of embolism (CSE) is crucial for stroke classification.
  • Understanding the contribution of identified CSE to stroke etiology is essential.

Purpose of the Study:

  • To determine the frequency and coexistent patterns of high- and medium-risk CSE.
  • To investigate how identified CSE contribute to stroke classification using the Trial of ORG 10172 in the Acute Stroke Treatment (TOAST) system.

Main Methods:

  • Analysis of data from 2,482 acute cerebral infarction patients in the Yonsei Stroke Registry over 10 years.
  • Cardiac sources were categorized into high- and medium-risk groups based on the TOAST classification.

Main Results:

  • At least one CSE was detected in 25% of patients (629/2,482).
  • Atrial fibrillation was the most common high-risk CSE, often coexisting with other CSE (69%).
  • High-risk CSE showed a higher correlation with cardioembolic stroke (83%) compared to medium-risk CSE (58%).

Conclusions:

  • The study elucidated the frequency and coexistent patterns of CSE in Korean stroke patients per TOAST classification.
  • A higher correlation between high-risk CSE and cardioembolic stroke was demonstrated.
Abstract

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