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"Cardioembolic profile" in patients with ischemic stroke: data from the analysis of 1037 cases

Alberto Chiti1, Nicola Giannini1, Eva Terni1

  • 1Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|April 25, 2015
PubMed

Insights

A simple profile using common data can identify stroke patients with atrial fibrillation. This helps detect hidden atrial fibrillation in undetermined stroke cases, guiding further diagnosis and treatment.

Area of Science:

  • Neurology
  • Cardiology
  • Medical Diagnostics

Background:

  • Distinguishing stroke causes is crucial for effective treatment.
  • Atrial fibrillation (AF) is a common cause of cardioembolic stroke.
  • Identifying AF-related strokes aids in preventing recurrent events.

Purpose of the Study:

  • To develop an "atrial fibrillation profile" using accessible clinical and instrumental data.
  • To differentiate stroke cases caused by AF from those due to large vessel atherothrombosis or small-vessel disease.

Main Methods:

  • 1037 ischemic stroke patients were analyzed, with 653 included after exclusions.
  • Patients were divided into two groups: 164 with AF-related stroke and 489 with atherothrombotic/lacunar stroke.
  • Clinical, echocardiographic, and neuroradiologic data were used for comparison.

Main Results:

  • A distinct phenotypic profile was observed between AF and atherothrombotic/lacunar stroke groups.
  • Key predictors for AF-related stroke included age >75 years, female sex, left atrial dilation, multiple infarct locations, and hemorrhagic transformation.
  • Logistic regression analysis identified significant indicators for cardioembolic stroke due to AF.

Conclusions:

  • A simple profile based on readily available data can characterize patients with stroke due to AF.
  • This profile may help identify patients with undetermined stroke at high risk for subclinical paroxysmal AF.
  • Further validation could lead to improved diagnostic work-up and therapeutic strategies.
Abstract

Keywords:
Ischemic strokeatherosclerosisatrial fibrillationcardioembolic predictorslacunar infarcts

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