Undetermined stroke with an embolic pattern-a common phenotype with high early recurrence risk

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 CHA(2)DS(2)-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.

Nieminen, T. (författare)
Haapaniemi, E. (författare)
Meretoja, A. (författare)
Rantanen, K. (författare)
Heikkinen, N. (författare)
Kinnunen, J. (författare)
Strbian, D. (författare)
Mustanoja, S. (författare)
Curtze, S. (författare)
Pakarinen, S. (författare)
Lehto, M. (författare)
Tatlisumak, TurgutGothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation(Swepub:gu)xtatlt (författare)
Göteborgs universitetInstitutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering (creator_code:org_t)

Ingår i:Annals of Medicine: Informa UK Limited47:5, s. 406-4130785-38901365-2060

Av författaren/redakt...: Putaala, J.; Nieminen, T.; Haapaniemi, E.; Meretoja, A.; Rantanen, K.; Heikkinen, N.; visa fler...; Kinnunen, J.; Strbian, D.; Mustanoja, S.; Curtze, S.; Pakarinen, S.; Lehto, M.; Tatlisumak, Turg ...; visa färre...

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