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Cardioembolic but not other stroke subtypes predict mortality independent of stroke severity at presentation

Latha Ganti Stead1, Rachel M Gilmore, M Fernanda Bellolio

  • 1Department of Emergency Medicine, Mayo Clinic, Rochester, MN 55905, USA.

Stroke Research and Treatment
|October 19, 2011
PubMed

Insights

Cardioembolic strokes, a subtype of acute ischemic stroke (AIS), are associated with significantly higher long-term mortality. Identifying stroke etiology using TOAST criteria is crucial for predicting patient outcomes.

Area of Science:

  • Neurology
  • Cardiology
  • Public Health

Background:

  • The etiology of acute ischemic stroke (AIS) significantly impacts patient management, prognosis, and recurrence risk.
  • Understanding stroke subtypes is essential for accurate risk stratification and treatment planning.

Purpose of the Study:

  • To investigate whether ischemic stroke subtypes, classified by the TOAST criteria, influence long-term mortality.
  • To identify specific stroke subtypes associated with increased mortality risk.

Main Methods:

  • An observational study was conducted on a consecutive cohort of 500 patients presenting with AIS at a tertiary academic center.
  • Patients were classified into TOAST criteria subtypes: large artery atherosclerosis, cardioembolic, small vessel disease, other causes, and unknown.
  • Survival rates were analyzed at 90, 180, and 360 days post-stroke.

Main Results:

  • Cardioembolic strokes exhibited the lowest survival rates at 90, 180, and 360 days (67.1%, 65.5%, and 58.2%, respectively).
  • Cryptogenic strokes, particularly those with insufficient information for subtype assignment, also showed poor survival (57.7% at 90 days).
  • Overall mortality was high, with 160 out of 500 patients dying within one year.

Conclusions:

  • The cardioembolic stroke subtype, identified using TOAST criteria, is a significant predictor of long-term mortality.
  • Accurate etiological classification of AIS is vital for predicting patient survival, even when accounting for age and stroke severity.

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