Cardio embolic stroke: Data from 145 cases at the Teaching Hospital of YalgadoOuedraogo, Ouagadougou, Burkina Faso

Abstract

Cardio embolic stroke: Data from 145 cases at the Teaching Hospital of YalgadoOuedraogo, Ouagadougou, Burkina Faso Introduction: Cardioembolic strokes represent a major public health concern worldwide due to associated high morbidity and mortality. Cardiac sources of embolism are leading cause of stroke after atherosclerosis. We aim to describe the epidemiological profile and outcome of cardioembolic stroke. Patients and methods: We retrospectively analyzed medical records of hospitalized patients who were admitted from January 1rst 2010 to May the 31th 2012 in the departments of Cardiology and Neurology at the Teaching University Hospital of YalgadoOuedraogo, Burkina Faso, West Africa. All patients diagnosed with ischaemic stroke on the basis of CT-scan and known to have a heart disease were included in the study. Results: Overall 582 cases of stroke were reported. Ischaemic stroke was observed in 370 patients (63.6%). Cardioembolic disease was reported in 145 patients (39.2%) among whom 73 female. Mean age was 61.7 ± 15 years (extremes: 21 - 90 years). Hypertension and active smoking were respectively observed in 65.5% and 25.5% of cases. Etiologic factors were atrial fibrillation (42.8%) and intra-cardiac blood clot (13.8%). Vitamin K antagonists were prescribed in 41.4% of cases. A two-week in-hospital follow-up reported hemorrhagic transformation in 8.3% of cases. In-hospital mortality rate was 15.2% and was significantly associated with hemorrhagic transformation (n = 10, RR = 9.24, CI95% = [5.1-16.8], p < 0.001) and congestive heart failure (n = n= 10, RR = 4, CI95%= [1.9-8.2], p < 0.001) and altered consciousness on admission (n= 8, RR = 2.7, CI95% = [1.3-5.8], p =0.009). Conclusion: Cardioembolic strokes are of frequent occurrence and associated with high in-hospital mortality. Therefore there is a need for early management of their etiologic factors.