Key result
Embolic strokes of undetermined source have heterogeneous underlying causes that may respond to different secondary prevention strategies, highlighting the need to distinguish these sources.
Embolic strokes of undetermined source (ESUS) are recognized as having heterogeneous underlying causes, primarily cardioembolic or atherosclerotic, which may require different secondary prevention strategies.
Embolic strokes of undetermined source (ESUS) comprise one-fifth of ischemic strokes. 1 Two large randomized controlled trials found that anticoagulation was not superior to aspirin for preventing recurrent stroke after ESUS, 2,3 refuting the hypothesis that the various underlying embolic sources in this population would be broadly amenable to anticoagulation.It is now accepted that ESUS occurs because of heterogeneous underlying causes and that these are mostly cardioembolic or atherosclerotic.4 Distinguishing between these underlying sources will likely prove important because they may respond to different strategies for secondary stroke prevention.Post hoc analyses of randomized trials suggest
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Kamel et al. (2023) conducted an editorial in Embolic strokes of undetermined source (ESUS). Embolic strokes of undetermined source have heterogeneous underlying causes that may respond to different secondary prevention strategies, highlighting the need to distinguish these sources.
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