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Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of
Rodrigo Bazan1, Gustavo José Luvizutto2, Gabriel Pereira Braga1
1Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, UNESP-Univ Estadual Paulista, Campus de Botucatu, Distrito de Rubião Jr, s/n, Botucatu, Brazil.
Introduction:
The presence of microembolic signals (MES) during the acute phase of stroke is poorly understood, and its role and clinical application in relation to risk stratification and prognosis in patients remain uncertain. We assessed the prevalence of spontaneous MES in acute stroke and their relationship with risk stratification, stroke recurrence, morbidity, and mortality.
Patients And Methods:
This was a prospective cohort study conducted in the Stroke Unit. The MES presence was evaluated by transcranial Doppler (TCD) in patients with ischemic stroke within 48 h. The outcomes (risk stratification, morbidity, mortality, and recurrence of a stroke) were followed up for 6 months. The relationship between risk stratification and MES was obtained by odds ratios and that between MES and stroke recurrence, morbidity, and mortality using multiple logistic regression; considering statistical significance at P < 0.05.
Results:
Of the 111 patients studied, 70 were men (63.1%) and 90 were white (81.1%), with a median age of 68 years. The MES frequency was 7%. There was a significant relationship between MES and symptomatic carotid disease (OR = 22.7; 95% CI 4.1-125.7; P < 0.001), a shorter time to monitoring (OR = 12.4; 95% CI 1.4-105.4; P = 0.02), and stroke recurrence (OR = 16.83; 95% CI 2.01-141; P = .009).
Discussion:
It was observed that the stroke recurrence adjusted for prior stroke was higher and earlier among patients with MES detection. In conclusion, MES demonstrated a significant correlation with symptomatic carotid disease and a shorter DELAY until monitoring, and could be a predictor for the early recurrence of stroke in the long term.
Insights
Microembolic signals (MES) detected in acute stroke patients correlate with symptomatic carotid disease and predict early stroke recurrence. This finding aids in risk stratification and prognosis for stroke patients.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Medical Diagnostics
Background:
- The clinical significance of microembolic signals (MES) in acute stroke remains unclear.
- Understanding MES is crucial for improving risk stratification and prognosis in stroke patients.
Purpose of the Study:
- To determine the prevalence of spontaneous MES in acute ischemic stroke patients.
- To investigate the association between MES and stroke risk stratification, recurrence, morbidity, and mortality.
Main Methods:
- Prospective cohort study involving 111 acute ischemic stroke patients.
- Microembolic signals (MES) assessed using transcranial Doppler (TCD) within 48 hours of stroke onset.
- Outcomes including risk stratification, morbidity, mortality, and stroke recurrence monitored for 6 months.
Main Results:
- MES were detected in 7% of patients.
- MES showed a significant association with symptomatic carotid disease (OR=22.7, P<0.001).
- MES presence correlated with a shorter time to monitoring (OR=12.4, P=0.02) and increased stroke recurrence (OR=16.83, P=0.009).
Conclusions:
- Microembolic signals (MES) are significantly correlated with symptomatic carotid disease.
- MES detection may serve as a predictor for early stroke recurrence.
- Further research can refine MES utility in long-term stroke prognosis.
