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Underlying causes o...
Underlying causes of cryptogenic stroke and TIA in the nordic atrial fibrillation and stroke (NOR-FIB) study : the importance of comprehensive clinical evaluation
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- Ratajczak-Tretel, B (author)
- University of Oslo,Østfold Hospital
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- Lambert, A Tancin (author)
- Østfold Hospital,University of Oslo
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- Al-Ani, R (author)
- Østfold Hospital
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- Arntzen, K (author)
- Nordland Hospital Bodø
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- Bakkejord, G K (author)
- Nordland Hospital Bodø
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- Bekkeseth, H M O (author)
- Innlandet Hospital Trust
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- Bjerkeli, V (author)
- Oslo university hospital
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- Eldøen, G (author)
- Molde Hospital
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- Gulsvik, A K (author)
- Diakonhjemmet Hospital
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- Halvorsen, B (author)
- Oslo university hospital,University of Oslo
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- Høie, G A (author)
- Østfold Hospital
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- Ihle-Hansen, H (author)
- Oslo university hospital,Baerum Hospital
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- Ingebrigtsen, S (author)
- University Hospital of North Norway
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- Kremer, C (author)
- Lund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Krogseth, S B (author)
- Vestfold Hospital
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- Kruuse, C (author)
- Gentofte Hospital
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- Kurz, M (author)
- Stavanger University Hospital
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- Nakstad, I (author)
- Drammen Hospital
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- Novotny, V (author)
- Haukeland University Hospital
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- Naess, H (author)
- Haukeland University Hospital
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- Qazi, R (author)
- Diakonhjemmet Hospital
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- Rezaj, M K (author)
- Stavanger University Hospital
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- Rørholt, D M (author)
- Molde Hospital
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- Steffensen, L H (author)
- University Hospital of North Norway
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- Sømark, J (author)
- Innlandet Hospital Trust
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- Tobro, H (author)
- Telemark Hospital
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- Truelsen, T C (author)
- Copenhagen University Hospital
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- Wassvik, L (author)
- Bispebjerg Hospital
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- Ægidius, K L (author)
- Bispebjerg Hospital
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- Atar, D (author)
- Oslo university hospital,University of Oslo
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- Aamodt, A H (author)
- Oslo university hospital,Norwegian University of Science and Technology
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(creator_code:org_t)
- 2023-03-21
- 2023
- English 10 s.
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In: BMC Neurology. - : Springer Science and Business Media LLC. - 1471-2377. ; 23:1
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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Abstract
Subject headings
Close
- BACKGROUND: Cryptogenic stroke is a heterogeneous condition, with a wide spectrum of possible underlying causes for which the optimal secondary prevention may differ substantially. Attempting a correct etiological diagnosis to reduce the stroke recurrence should be the fundamental goal of modern stroke management.METHODS: Prospective observational international multicenter study of cryptogenic stroke and cryptogenic transient ischemic attack (TIA) patients clinically monitored for 12 months to assign the underlying etiology. For atrial fibrillation (AF) detection continuous cardiac rhythm monitoring with insertable cardiac monitor (Reveal LINQ, Medtronic) was performed. The 12-month follow-up data for 250 of 259 initially included NOR-FIB patients were available for analysis.RESULTS: After 12 months follow-up probable stroke causes were revealed in 43% patients, while 57% still remained cryptogenic. AF and atrial flutter was most prevalent (29%). In 14% patients other possible causes were revealed (small vessel disease, large-artery atherosclerosis, hypercoagulable states, other cardioembolism). Patients remaining cryptogenic were younger (p < 0.001), had lower CHA 2DS 2-VASc score (p < 0.001) on admission, and lower NIHSS score (p = 0.031) and mRS (p = 0.016) at discharge. Smoking was more prevalent in patients that were still cryptogenic (p = 0.014), while dyslipidaemia was less prevalent (p = 0.044). Stroke recurrence rate was higher in the cryptogenic group compared to the group where the etiology was revealed, 7.7% vs. 2.8%, (p = 0.091). CONCLUSION: Cryptogenic stroke often indicates the inability to identify the cause in the acute phase and should be considered as a working diagnosis until efforts of diagnostic work up succeed in identifying a specific underlying etiology. Timeframe of 6-12-month follow-up may be considered as optimal.TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT02937077, EudraCT 2018-002298-23.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Keyword
- Humans
- Atrial Fibrillation/complications
- Ischemic Attack, Transient/complications
- Stroke/epidemiology
- Ischemic Stroke/complications
- Causality
- Electrocardiography, Ambulatory/adverse effects
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Ratajczak-Tretel ...
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Lambert, A Tanci ...
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Al-Ani, R
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Arntzen, K
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Bakkejord, G K
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Bekkeseth, H M O
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show more...
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Bjerkeli, V
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Eldøen, G
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Gulsvik, A K
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Halvorsen, B
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Høie, G A
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Ihle-Hansen, H
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Ingebrigtsen, S
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Kremer, C
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Krogseth, S B
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Kruuse, C
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Kurz, M
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Nakstad, I
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Novotny, V
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Naess, H
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Qazi, R
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Rezaj, M K
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Rørholt, D M
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Steffensen, L H
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Sømark, J
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Tobro, H
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Truelsen, T C
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Wassvik, L
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Ægidius, K L
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Atar, D
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Aamodt, A H
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
- Articles in the publication
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BMC Neurology
- By the university
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Lund University