EXACTLY HOW IS THIS GETTING SURVIVORS BETTER RECOVERY?
The only goal in stroke is 100% recovery, don't the mentors and senior researchers know that? All research should be linked to that goal.
Reclassification and risk stratification of embolic stroke of undetermined source by ASCOD phenotyping
Abstract
Background:
Vascular diseases underlying stroke, including atherosclerosis, small-vessel disease (SVD), and cardioembolic pathology, can be present in patients with embolic stroke of undetermined source (ESUS), although these are not direct causes of stroke.
Aims:
To describe the frequency and degree of the 3 major diseases using ASCOD phenotyping and to assess their prognostic implications in ESUS.
Methods:
In this prospective observational study, 221 patients with ESUS within 1 week of onset were consecutively enrolled and followed up for 1 year. Vascular diseases associated with stroke were assessed using the ASCOD classification. The primary outcome was a composite of major adverse cardiovascular events (MACEs).
Results:
Among 221 patients, 135 (61.1%), 102 (46.2%), and 107 (48.4%) had any grade of atherosclerosis (A2 or A3), SVD (S3), and cardiac pathology (C2 or C3), respectively. ESUS patients graded as A2 or A3 (i.e., ipsilateral atherosclerotic plaque, contralateral ≥50% stenosis, or aortic arch plaque) were at a significantly higher risk of MACE than those graded as A0 (i.e., no atherosclerotic disease) (adjusted hazard ratio [95% confidence interval], 2.40 [1.01–5.72]). No differences were observed in the event risk between patients with S3 (i.e., magnetic resonance imaging evidence of SVD) and S0 (i.e., no SVD) and between those with C2 or C3 (i.e., presence of any cardiac pathology) and C0 (i.e., no cardiac abnormalities).
Conclusions:
ASCOD grade A2 or A3 was predictive of MACE in ESUS patients. Reclassification of ESUS using ASCOD phenotyping provides important clues for risk prediction and may guide optimal management strategies.
No comments:
Post a Comment