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Cardioembolic Stroke
1From the Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (H.K.) and Department of Neurology, Weill Cornell Medicine, New York, NY (H.K.); and Department of Medicine and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (J.S.H.). hok9010@med.cornell.edu.
Circulation Research
|February 4, 2017
Summary
Cardiac embolism is a growing cause of ischemic stroke. Strategies include identifying embolic stroke of undetermined source, often linked to subclinical atrial fibrillation or atrial cardiomyopathy, and using novel anticoagulants.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Cardiac embolism is an increasing cause of ischemic stroke.
- Many cryptogenic strokes may originate from embolism, leading to the concept of embolic stroke of undetermined source.
- Subclinical atrial fibrillation and atrial cardiomyopathy are increasingly recognized as sources of cardioembolic stroke.
Purpose of the Study:
- To review potential strategies for preventing the rise in cardioembolic stroke.
- To highlight the role of atrial fibrillation and atrial cardiomyopathy in stroke etiology.
- To discuss the application of novel anticoagulants and risk factor management.
Main Methods:
- Review of recent clinical trials and emerging evidence.
- Discussion of diagnostic approaches like prolonged heart rhythm monitoring.
- Analysis of therapeutic options including non-vitamin K antagonist oral anticoagulants.
Main Results:
- Embolic stroke of undetermined source is a distinct target for investigation.
- Subclinical atrial fibrillation and atrial cardiomyopathy are significant contributors to stroke.
- Non-vitamin K antagonist oral anticoagulants show promise in preventing cardioembolic stroke.
Conclusions:
- Early diagnosis of atrial fibrillation and management of atrial cardiomyopathy are crucial.
- Novel anticoagulants and comprehensive vascular risk factor management are key to reducing cardioembolic stroke.
- Improved imaging and anticoagulation strategies may prevent stroke from myocardial infarction and heart failure.
Keywords:
anticoagulantsatrial cardiomyopathyatrial fibrillationatrial myopathyembolismheart failurestrokeMore Related Videos
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