AI Article Synopsis
- Undetermined strokes with an embolic pattern (USEP) are a common type of ischemic stroke, and this study compared their frequency and outcomes against cardioembolic strokes with known sources and non-cardioembolic strokes.
- Among 540 stroke patients, 23.5% were classified as USEP, which had distinct characteristics such as being younger and having fewer comorbidities compared to cardioembolic cases.
- Despite having seemingly favorable risk factors, patients with USEP experienced a greater risk of recurrent stroke, exhibiting a 10% recurrence rate, higher than both cardioembolic and non-cardioembolic stroke patients.
Article Abstract
Introduction: Undetermined strokes with an embolic pattern (USEP) represent a common phenotype. We assessed their frequency and compared USEP with cardioembolic stroke with a known source and non-cardioembolic stroke etiology.
Methods: Study patients were 540 consecutive ischemic stroke patients admitted to Helsinki University Hospital with primary end-point of recurrent stroke in a 21-month follow-up. Cox regression adjusting for CHA2DS2-VASc and anticoagulation estimated the risk of USEP on recurrent stroke.
Results: A total of 229 (42.4%) patients had a non-cardioembolic stroke etiology, 184 (34.1%) had a cardioembolic stroke with a known source, and 127 (23.5%) were classified as USEP. USEP patients had less diabetes and prior TIA, with more severe symptoms than the non-cardioembolic stroke cases. They were younger, had fewer comorbidities, and less severe symptoms than the cardioembolic stroke patients. Cumulative risk of recurrent stroke was 10.0% (95% CI 4.1%-15.9%) for USEP, 5.0% (1.1%-8.9%) for cardioembolic strokes, and 5.0% (3.0%-7.0%) for non- cardioembolic strokes (P = 0.089). USEP associated with a higher risk of recurrent stroke compared to non-cardioembolic strokes (hazard ratio 2.36, 95% CI 1.02-5.47; P = 0.046) and cardioembolic stroke with a known source (1.83, 1.07-3.14; P = 0.028).
Conclusions: Despite their younger age and more favorable risk factor profile compared with other phenotypes, USEP exhibited a high risk of stroke recurrence.
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| http://dx.doi.org/10.3109/07853890.2015.1057612 | DOI Listing |
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