Distribution of Cardioembolic Stroke: A Cohort Study

Area of Science:

• Neurology
• Cardiology
• Stroke Medicine

Background:

• Cardiac origin of ischemic stroke is more common than previously thought.
• Identifying patients who benefit from cardiac work-up is challenging when obvious cardiac pathology is absent.
• This study investigated the association between posterior circulation stroke and cardioembolic sources.

Purpose of the Study:

• To test the hypothesis that thromboembolic stroke in the posterior circulation is more frequently of cardiac origin.
• To identify patient and disease characteristics associated with a cardiac etiology in ischemic stroke.

Main Methods:

• A multicenter observational study of 3,311 consecutive ischemic stroke patients.
• Comparison of posterior stroke location proportions between cardiac and non-cardiac stroke etiologies.
• Poisson regression and stepwise backward regression analyses were used.

Main Results:

• No statistically significant difference in posterior stroke location was found between cardiac (28%) and other stroke origins (25%).
• Older age, higher NIHSS scores, and absence of atherosclerosis risk factors (smoking, hyperlipidemia, CAD) were associated with cardiac etiology.

Conclusions:

• Posterior stroke localization alone does not necessitate further cardiac examination.
• Factors such as advanced age and higher NIHSS scores are stronger indicators of a cardiac source for ischemic stroke.