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Undetermined stroke with an embolic pattern--a common phenotype with high early recurrence risk
Jukka Putaala1, Tuomo Nieminen, Elena Haapaniemi
1a Neurology, Helsinki University Hospital and University of Helsinki , Finland.
Annals of Medicine
|July 31, 2015
Summary
Undetermined strokes with an embolic pattern (USEP) are common and associated with a higher risk of recurrent stroke, even in younger patients. This highlights the need for careful management of USEP to prevent future events.
Area of Science:
- Neurology
- Cardiology
- Stroke Medicine
Background:
- Undetermined strokes with an embolic pattern (USEP) are a frequent clinical presentation.
- Understanding the frequency and outcomes of USEP is crucial for stroke management.
- Comparison with known cardioembolic and non-cardioembolic stroke etiologies is needed.
Purpose of the Study:
- To determine the frequency of USEP.
- To compare the characteristics and recurrence risk of USEP with other stroke etiologies.
- To assess the risk of recurrent stroke in USEP patients.
Main Methods:
- A cohort of 540 ischemic stroke patients was analyzed.
- Patients were followed for recurrent stroke over 21 months.
- Cox regression, adjusting for CHA2DS2-VASc and anticoagulation, estimated USEP's risk for recurrent stroke.
Main Results:
- USEP accounted for 23.5% of ischemic strokes.
- USEP patients were younger with fewer comorbidities than cardioembolic stroke patients.
- USEP was associated with a significantly higher risk of recurrent stroke compared to non-cardioembolic and known cardioembolic strokes.
Conclusions:
- USEP represents a significant proportion of ischemic strokes.
- Despite a seemingly favorable risk factor profile, USEP carries a high risk of stroke recurrence.
- Further research into the mechanisms and optimal treatment of USEP is warranted.
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