Clinical features of recurrent embolization in acute cardioembolic stroke.

Yasaka, Masahiro; Yamaguchi, Takenori; Oita, Jiro; Sawada, Toru; Shichiri, Mototada; Omae, T

doi:10.1161/01.str.24.11.1681

Cited by 54 publications

(35 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recurrent embolism to the brain, particularly during the first 5 days after onset, is one of the most serious problems in patients with cardioembolic stroke [53, 54, 55, 56, 57, 58, 59]. In our study, early stroke recurrence was associated with an in-hospital mortality of 77.8% with an odds ratio of 33.5 in the logistic regression analysis.…”

Section: Discussionsupporting

confidence: 47%

Predictive Clinical Factors of In-Hospital Mortality in 231 Consecutive Patients with Cardioembolic Cerebral Infarction

et al. 1998

View full text Add to dashboard Cite

Cardioembolic cerebral infarction is a subtype of stroke with a high mortality. The purpose of this study was to determine predictors of in-hospital mortality in 231 consecutive patients with cardioembolic stroke by means of a multivariate analysis. Three predictive models were constructed. A first model was based on demographic, anamnestic and clinical variables collected at the bedside examination (total 8 variables). A second model was based on clinical and neuroimaging variables (total 10 variables). A third model was based on the aforementioned clinical and neuroimaging variables and the presence of early recurrent embolism (total 11 variables). Deteriorated level of consciousness, limb weakness, presence of congestive heart failure, male gender, and age appeared to be independent prognostic factors of in-hospital mortality in the predictive model based on clinical variables and in the predictive model based on clinical and neuroimaging variables. In addition to these variables, early recurrent embolization was selected in the third predictive model. In the first two models, setting a cut-off point of 0.50 for predicting vital status at hospital discharge resulted in a sensitivity of 60%, a specificity of 89% and a total correct classification of 81%. The corresponding values of the third model were 62, 89 and 81%, respectively. These data may help clinicians to establish an early prognosis of this stroke subtype more accurately as well as to allocate patients with cardioembolic stroke in clinical trials correctly.

show abstract

Section: Discussionsupporting

confidence: 47%

Predictive Clinical Factors of In-Hospital Mortality in 231 Consecutive Patients with Cardioembolic Cerebral Infarction

et al. 1998

View full text Add to dashboard Cite

show abstract

“…The failure to prevent minor stroke in patients with INR above 1.6 may be related to the mechanism of stroke recurrence. Although it is well known that cardioembolic stroke is prone to recur (19,20), some minor strokes fromthe other causes, such as atherothrombotic or lacunar infarction, may occur even in patients with higher INR. Such strokes are usually less severe and do not respond as well to anticoagulant prevention as cardioembolic stroke.…”

Section: Methodsmentioning

confidence: 99%

Optimal Intensity of International Normalized Ratio in Warfarin Therapy for Secondary Prevention of Stroke in Patients with Non-valvular Atrial Fibrillation.

2001

View full text Add to dashboard Cite

“…50 The risk of recurrent brain embolism in the 14 days following cardioembolic stroke has been reported to be 13.7%, with the highest risk found in the 2 days immediately after the stroke. 51 There are, therefore, subgroups of patients who can be identified as being at higher-than-average risk of further ischemic events and who potentially could benefit from longer-term neuroprotection. For prolonged treatment to be practicable it would ideally be available in an orally active form and have an acceptable side-effect profile.…”

Section: Prolonged Therapy For Certain Patients?mentioning

confidence: 99%

Duration of Neuroprotective Treatment for Ischemic Stroke

Dyker

Lees

1998

Stroke

View full text Add to dashboard Cite

Background-The therapeutic time window for thrombolysis appears to be extremely short, probably because of the hemorrhagic complications associated with late reperfusion of ischemic brain tissue. Other neuroprotective forms of treatment continue to be developed, although their efficacy has yet to be conclusively proved in patients. The duration of treatment in recent phase 3 trials ranges from a single bolus injection to 12 weeks of oral therapy. Summary of Review-In this article we discuss the factors that should influence the choice of route and duration of treatment.Excitotoxic injury following stroke evolves over at least 4 hours in rodents and possibly beyond 48 hours in humans. In addition, autoregulation and local cerebral perfusion are deranged for approximately 72 hours in patients with stroke. Neuroprotection should provide cover during this critical time. Conclusions-Important considerations influencing drug administration should include the pharmacology of the compound (pharmacokinetics, mechanism of action, preclinical toxicity, and pharmaceutical properties), its safety and tolerability in patients, and the likelihood of continuing or recurrent cerebral ischemia, along with practical issues such as ease of administration and interactions with early rehabilitation and other therapies. Optimization of treatment will be possible only when neuroprotection is confirmed to be effective. (Stroke. 1998;29:535-542.)

show abstract

Clinical features of recurrent embolization in acute cardioembolic stroke.

Cited by 54 publications

References 17 publications

Predictive Clinical Factors of In-Hospital Mortality in 231 Consecutive Patients with Cardioembolic Cerebral Infarction

Predictive Clinical Factors of In-Hospital Mortality in 231 Consecutive Patients with Cardioembolic Cerebral Infarction

Optimal Intensity of International Normalized Ratio in Warfarin Therapy for Secondary Prevention of Stroke in Patients with Non-valvular Atrial Fibrillation.

Duration of Neuroprotective Treatment for Ischemic Stroke

Contact Info

Product

Resources

About