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Embolic strokes of undetermined source: Prevalence and patient features in the ESUS Global Registry

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机构: [1]McMaster Univ, Hamilton Hlth Sci, Dept Med Neurol, Hamilton, ON, Canada; [2]Univ Leuven, Dept Cardiovasc Sci, Leuven, Belgium; [3]McMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Hamilton, ON, Canada; [4]Bayer Healthcare Pharmaceut, Whippany, NJ USA; [5]Inst Nacl Neurol & Neurocirug, Mexico City, DF, Mexico; [6]Univ Galway, Galway, Ireland; [7]FLENI, Neurol Res Inst, Buenos Aires, DF, Argentina; [8]Univ Western Australia, Sir Charles Gairdner Hosp, Sch Med & Pharmacol, Perth, WA 6009, Australia; [9]Seoul Natl Univ Hosp, Dept Neurol, Seoul 110744, South Korea; [10]Hop Xavier Bichat, Dept Neurol, Paris, France; [11]Ctr Hosp & Univ Coimbra, Coimbra, Portugal; [12]Pirogov Russian Natl Res Med Univ, Moscow, Russia; [13]Univ Ziekenhuis Brussel, Brussels, Belgium; [14]Irmandade Santa Casa Misericordia Sao Paulo, Sao Paulo, Brazil; [15]Hosp Univ Penn, Dept Neurol, 3400 Spruce St, Philadelphia, PA 19104 USA; [16]Univ Roma La Sapienza, Dept Neurol & Psychiat, Piazzale Aldo Moro 5, I-00185 Rome, Italy; [17]Univ Heidelberg Hosp, Dept Neurol, Heidelberg, Germany; [18]Tokyo Womens Med Univ, Dept Neurol, Tokyo, Japan; [19]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Beijing, Peoples R China; [20]Univ Glasgow, Queen Elizabeth Hosp, Inst Neurosci & Physiol, Glasgow, Lanark, Scotland; [21]Univ Amsterdam, Acad Med Ctr, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands; [22]Semmelweis Univ, Dept Neurol, H-1085 Budapest, Hungary; [23]McMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Dept Med Cardiol, Hamilton, ON, Canada; [24]McMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Dept Med Neurol, DBCVSRI C4-105,237 Barton St East, Hamilton, ON L8L 2X2, Canada
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关键词: Stroke embolism cerebral embolism atrial fibrillation stroke-etiology diagnostic evaluation

摘要:
Background: Recent evidence supports that most non-lacunar cryptogenic strokes are embolic. Accordingly, these strokes have been designated as embolic strokes of undetermined source (ESUS). Aims: We undertook an international survey to characterize the frequency and clinical features of ESUS patients across global regions. Methods: Consecutive patients hospitalized for ischemic stroke were retrospectively surveyed from 19 stroke research centers in 19 different countries to collect patients meeting criteria for ESUS. Results: Of 2144 patients with recent ischemic stroke, 351 (16%, 95% CI 15% to 18%) met ESUS criteria, similar across global regions (range 16% to 21%), and an additional 308 (14%) patients had incomplete evaluation required for ESUS diagnosis. The mean age of ESUS patients (62 years; SD = 15) was significantly lower than the 1793 non-ESUS ischemic stroke patients (68 years, p <= 0.001). Excluding patients with atrial fibrillation (n = 590, mean age = 75 years), the mean age of the remaining 1203 non-ESUS ischemic stroke patients was 64 years (p = 0.02 vs. ESUS patients). Among ESUS patients, hypertension, diabetes, and prior stroke were present in 64%, 25%, and 17%, respectively. Median NIHSS score was 4 (interquartile range 2-8). At discharge, 90% of ESUS patients received antiplatelet therapy and 7% received anticoagulation. Conclusions: This cross-sectional global sample of patients with recent ischemic stroke shows that one-sixth met criteria for ESUS, with additional ESUS patients likely among those with incomplete diagnostic investigation. ESUS patients were relatively young with mild strokes. Antiplatelet therapy was the standard antithrombotic therapy for secondary stroke prevention in all global regions.

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出版当年[2015]版:
大类 | 2 区 医学
小类 | 3 区 外周血管病
最新[2023]版:
大类 | 2 区 医学
小类 | 2 区 临床神经病学 2 区 外周血管病
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出版当年[2014]版:
Q1 PERIPHERAL VASCULAR DISEASE
最新[2023]版:
Q1 CLINICAL NEUROLOGY Q1 PERIPHERAL VASCULAR DISEASE

影响因子: 最新[2023版] 最新五年平均 出版当年[2014版] 出版当年五年平均 出版前一年[2013版] 出版后一年[2015版]

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第一作者机构: [1]McMaster Univ, Hamilton Hlth Sci, Dept Med Neurol, Hamilton, ON, Canada;
通讯作者:
通讯机构: [1]McMaster Univ, Hamilton Hlth Sci, Dept Med Neurol, Hamilton, ON, Canada; [24]McMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Dept Med Neurol, DBCVSRI C4-105,237 Barton St East, Hamilton, ON L8L 2X2, Canada
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