Predictors of Long-Term Mortality in Patients With Ischemic Stroke Referred for Transesophageal Echocardiography

Abstract

Background and Purpose-Findings on transesophageal echocardiography (TEE) after ischemic stroke predict recurrent embolic events and prompt therapy; however, the additive predictive power of TEE findings on long-term mortality is unknown. Our goal was to study the impact of TEE findings on all cause mortality in ischemic stroke patients referred for TEE. Methods-We reviewed 245 consecutive patients who underwent TEE for ischemic stroke of undetermined origin (2000 to 2003). Long-term survival was assessed using the Social Security Death Index. Results-In a mean follow-up period of 3.0 (1.4 to 4.

Prognostic role of aortic atherosclerosis and coronary flow reserve in patients with suspected coronary artery disease

“…Although the presence of "complex" AA (ulcerated plaques, mobile plaques) is a powerful predictor of ischemic stroke [17], its role in the prediction of other cardiovascular events is controversial [18]. In agreement with the study of Ward et al [18], highgrade AA predicted survival in our study. However, only diabetes and CFR independently predicted survival.…”

Heart failure in acute ischemic stroke

“…An apparently obvious explanation for the independent relationship between HF and poor outcome in stroke patients may be related to its underlying causes: atherosclerotic coronary disease, hypertensive disease, and valvular disease. These factors are associated with a higher atherosclerotic burden [26], endothelial dysfunction [13], more complex treatments, and a higher risk of death [22] or systemic-embolic complications [9]. However, these considerations are present in both conditions of HF.…”

Use of Carotid Intima-Media Thickness to Identify Patients With Ischemic Stroke and Transient Ischemic Attack With Low Yield of Cardiovascular Sources of Embolus on Transesophageal Echocardiography

“…18 -21 Additionally, we have previously reported that complex aortic plaques are the only individual CSE found on TEE after ischemic stroke to be associated with an increased mortality. 11 We included complex aortic plaques in all thoracic locations in our definition of a positive TEE finding because we felt this definition was relevant to clinical practice. Although the evidence that descending aortic atheroma can cause central nervous system events is limited, 22,23 studies addressing prognostic and therapeutic implications of complex aortic atheroma found on TEE after embolic events have included plaques in all thoracic locations.…”