Abstract
Objective: To investigate the prevalence and clinical determinants of atrial cardiopathy in patients with embolic stroke of unknown source (ESUS) vs other subtypes of stroke. Material and Method: 1881 consecutive patients with ischemic stroke, we compared the prevalence of atrial cardiopathy between ESUS patients and patients with ischemic stroke related to large artery atherosclerosis (LAA) and small vessel disease (SVD). Baseline characteristics were also compared between ESUS and other etiologies. We exclude 680 patients with cardioembolism due to atrial fibrillation, other causes of stroke 134 patient and 295 transient ischemic attack. Results: 690 (37,2%) patients met ESUS diagnostic criteria, while others were classified into LAA (n = 397, 21,105%) and SVD (n = 794, 42,21, %). Prevalence of atrial cardiopathy was higher in ESUS patients compared to noncardioembolic stroke patients (27.6% ESUS vs 11.1% LAA, p= 0.001; and 27.6 % ESUS vs 10,9 SVD, p = 0.001). ESUS patients were younger, with lower prevalence of hypertension and higher higher total cholesterol and low-density lipoprotein levels. Conclusions: prevalence of atrial cardiopathy is higher in ESUS than in nonembolic stroke. it is still unclear if they may benefit from anticoagulation. Further efforts are necessary to provide better characterization of the ESUS population in order to develop better stroke preventive strategies.
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