Key result
The optimum antithrombotic prophylaxis regimen for cryptogenic stroke, which accounts for approximately 25% of ischemic strokes, remains undefined.
Highlights that approximately 25% of ischemic strokes are cryptogenic, and the optimal secondary prevention strategy for this population remains undefined.
After an acute ischemic stroke, clinicians pursue further diagnostic assessment to identify the most plausible causes and tailor secondary prevention strategies. Available treatments with a high level of evidence for reducing recurrence stroke risk might include long-term oral anticoagulation in patients with a major-risk cardioembolic source (atrial fibrillation, prosthetic valves, etc), carotid endarterectomy in minor ischemic stroke related to moderate to severe internal carotid artery atherosclerotic stenosis, and best-practice medical management in those with lacunar stroke due to cerebral small vessel disease.1 However, ≈25% of patients who have had ischemic stroke (an estimated 300,000 new strokes per year in North America and Europe) have no cause identified.2 These strokes, usually called cryptogenic (i.e., of unknown cause), typically include nonlacunar infarcts without an identified cardioembolic source or occlusive atherosclerotic disease. Compared to all other major stroke subtypes, little progress has been achieved in the secondary prevention of this common but obscure entity, and the optimum antithrombotic prophylaxis regimen remains undefined.
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Andreas Charidimou (2017) conducted an editorial in Cryptogenic stroke / Embolic stroke of undetermined source. The optimum antithrombotic prophylaxis regimen for cryptogenic stroke, which accounts for approximately 25% of ischemic strokes, remains undefined.
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