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Characteristics and prognosis of patients with embolic stroke of undetermined source in China

Xiaomeng Yang1, Jing Jing1,2, Xia Meng3

  • 1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

International Journal of Stroke : Official Journal of the International Stroke Society
|June 14, 2021
PubMed

Insights

Embolic stroke of undetermined source (ESUS) is common in China, affecting 28.3% of ischemic stroke patients. This condition shows higher stroke recurrence than previously reported, highlighting the need for further research into its causes and management.

Area of Science:

  • Neurology
  • Cardiovascular Research
  • Epidemiology

Background:

  • Embolic stroke of undetermined source (ESUS) represents a significant proportion of ischemic stroke cases.
  • Understanding the specific characteristics and outcomes of ESUS is crucial for effective patient management.
  • The Third China National Stroke Registry provides a robust platform for investigating ESUS in a large, diverse population.

Purpose of the Study:

  • To determine the frequency of embolic stroke of undetermined source (ESUS) in a Chinese population.
  • To identify risk factors and analyze the natural history and prognosis of ESUS.
  • To compare ESUS with other ischemic stroke subtypes.

Main Methods:

  • Prospective enrollment of 15,166 patients with ischemic stroke or transient ischemic attack in the Third China National Stroke Registry (August 2015 - March 2018).
  • Detailed baseline characteristics, risk factors, and stroke risk assessment for all participants.
  • Comparative analysis of ESUS patients against those with cardioembolic stroke and small vessel disease.

Main Results:

  • 28.3% of 8,528 ischemic stroke patients with standard work-up were diagnosed with ESUS (mean age 61, 70% male).
  • ESUS patients exhibited a higher prevalence of nonstenosing large artery atherosclerosis compared to cardioembolic stroke and small vessel disease.
  • The cumulative probability of stroke recurrence at 3 months and 1 year for ESUS was 5.59% and 8.74%, respectively.

Conclusions:

  • Embolic stroke of undetermined source (ESUS) is a frequent cause of ischemic stroke in China.
  • Stroke recurrence rates in ESUS patients appear higher than previously documented.
  • Nonstenosing large artery atherosclerosis is a more common finding in ESUS patients compared to other stroke subtypes.
Abstract

Keywords:
Embolic stroke of undetermined sourceetiologyprognosis

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