Background and Purpose-Limited data exist concerning obesity and survival in patients after acute stroke. The objective of this study was to investigate the association between obesity and survival in patients with acute first-ever stroke. Methods-Patients were prospectively investigated based on a standard diagnostic protocol over a period of 16 years.Evaluation was performed on admission, at 7 days, at 1, 3, and 6 months after discharge, and yearly thereafter for up to 10 years after stroke. The study patients were divided into 3 groups according to body mass index (BMI): normal weight (Ͻ25 kg/m 2 ), overweight (25-29.9 kg/m 2 ), and obese (Ն30 kg/m 2 ). Overall survival during follow-up was the primary end point. The secondary end point was the overall composite cardiovascular events over the study period.Results-Based on our inclusion criteria, 2785 patients were recruited. According to BMI, 1138 (40.9%)
A new clinical entity termed Embolic Stroke of Undetermined Source (ESUS) was recently introduced by the Cryptogenic Stroke/ESUS International Working Group, which describes stroke patients for whom the source of embolism remains undetected despite recommended investigation; potential embolic sources include the mitral and aortic valves, the left cardiac chambers, the proximal cerebral arteries of the aortic arch, and the venous system via paradoxical embolism. 1 ESUS has been proposed as a potential therapeutic entity with an indication for anticoagulation, a hypothesis which is currently tested in randomized controlled trials. 2,3Recently, we presented a descriptive analysis of an ESUS population originating from the Athens Stroke Registry. 4 Among the overall stroke population, 10% of patients were classified as ESUS. 4 These strokes were of mild-moderate severity, and covert atrial fibrillation (AF) was identified as the underlying etiopathogenetic mechanism in ≈40% of ESUS patients. 4 In routine clinical practice, and based on randomized studies, 5,6 the vast majority of ESUS patients are treated with antiplatelets for secondary stroke prevention. However, given that covert AF is the underlying pathogenesis in ≈40% of Background and Purpose-Information about outcomes in Embolic Stroke of Undetermined Source (ESUS) patients is unavailable. This study provides a detailed analysis of outcomes of a large ESUS population. Methods-Data set was derived from the Athens Stroke Registry. ESUS was defined according to the Cryptogenic Stroke/ ESUS International Working Group criteria. End points were mortality, stroke recurrence, functional outcome, and a composite cardiovascular end point comprising recurrent stroke, myocardial infarction, aortic aneurysm rupture, systemic embolism, or sudden cardiac death. We performed Kaplan-Meier analyses to estimate cumulative probabilities of outcomes by stroke type and Cox-regression to investigate whether stroke type was outcome predictor. Results-2731 patients were followed-up for a mean of 30.5±24.1months. The aim of the present study is to provide a detailed analysis of outcomes of a large ESUS population derived from a large prospective stroke registry during a long follow-up period. Methods Study Population and DefinitionsThe study population was derived from the Athens Stroke Registry, which includes all consecutive patients with an acute first-ever ischemic stroke admitted in Alexandra University Hospital, Athens, Greece, between June 1992 and December 2011. 7 Patients with recurrent stroke have not been included in the registry. The scientific use of the data collected in the Athens Stroke Registry was approved by the local Ethics Committee.The methodology followed to register data in the Athens Stroke Registry was described elsewhere. 4 With regard to AF detection, all patients had a 12-lead ECG at admission. In patients on sinus rhythm, AF paroxysms were sought by (1) repeated ECGs during hospital stay, (2) continuous ECG monitoring for 1 week or until discharge for p...
Prestroke CHADS2 and CHA2DS2-VASc scores predict long-term stroke outcomes in non-AF patients with acute ischemic stroke. These scores may provide a simple way of stroke prognostic risk stratification among non-AF stroke patients.
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