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Embolic Stroke of Undetermined Source (ESUS) and Stroke in Atrial Fibrillation Patients: not so Different after all?
Scavasine, Valeria Cristina; Ribas, Gustavo da Cunha; Costa, Rebeca Teixeira; Ceccato, Guilherme Henrique Weiler; Zétola, Viviane de Hiroki Flumignan; Lange, Marcos Christiano.
  • Scavasine, Valeria Cristina; Universidade Federal do Paraná. Hospital de Clínicas. Department of Neurology. Curitiba. BR
  • Ribas, Gustavo da Cunha; Universidade Federal do Paraná. Hospital de Clínicas. Department of Neurology. Curitiba. BR
  • Costa, Rebeca Teixeira; Universidade Federal do Paraná. Hospital de Clínicas. Department of Neurology. Curitiba. BR
  • Ceccato, Guilherme Henrique Weiler; Universidade Federal do Paraná. Hospital de Clínicas. Department of Neurology. Curitiba. BR
  • Zétola, Viviane de Hiroki Flumignan; Universidade Federal do Paraná. Hospital de Clínicas. Department of Neurology. Curitiba. BR
  • Lange, Marcos Christiano; Universidade Federal do Paraná. Hospital de Clínicas. Department of Neurology. Curitiba. BR
Int. j. cardiovasc. sci. (Impr.) ; 34(5): 517-522, Sept.-Oct. 2021. tab
Article in English | LILACS | ID: biblio-1340060
ABSTRACT
Abstract

Background:

Stroke related to atrial fibrillation (AF) is associated with high recurrence and mortality rates. Embolic Stroke of Undetermined Source (ESUS) is associated with fewer vascular risk factors, less disability, and a high recurrence rate.

Objective:

To compare risk factors, functional outcomes and the occurrence of primary endpoint (a composite of recurrent stroke, cardiovascular death, and myocardial infarction) between AF stroke and ESUS patients.

Method:

A retrospective analysis was conducted including all consecutive patients with first-ever ischemic stroke admitted to the Hospital de Clinicas (Clinical Hospital) of the Federal University of Paraná from October 2012 to January 2017 (n=554). There were 61 patients with stroke due to AF and 43 due to ESUS. Both groups were compared for demographic characteristics and vascular risk factors. Logistic regression models were performed to assess the impact of each variable on the primary endpoint in a 12-month follow-up. Statistical significance was considered for p-values < 0.05.

Results:

ESUS patients, as compared to AF patients, were younger and more likely to be smokers. ESUS patients presented a mean CHADS2VASc score of 4, while the AF group presented a score of 5 (p <0.001). The primary endpoint was observed in 9 (20.9%) ESUS and 11 (18.0%) AF patients over a 12-month period (p=0.802). Higher glucose levels upon hospital admission (p=0.020) and a higher modified Rankin Scale upon hospital discharge (p=0.020) were predictors of the primary endpoint occurrence.

Conclusion:

AF and ESUS stroke patients presented very similar independence rates upon hospital discharge and outcomes after 12 months, despite some baseline differences, including stroke recurrence, vascular death, and myocardial infarction.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Stroke / Heart Disease Risk Factors / Sociodemographic Factors Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: English Journal: Int. j. cardiovasc. sci. (Impr.) Journal subject: Cardiology Year: 2021 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal do Paraná/BR

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Full text: Available Index: LILACS (Americas) Main subject: Stroke / Heart Disease Risk Factors / Sociodemographic Factors Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: English Journal: Int. j. cardiovasc. sci. (Impr.) Journal subject: Cardiology Year: 2021 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal do Paraná/BR