Key result
Embolic stroke patterns fail to predict ESUS or new atrial fibrillation.
Why the study?
Atrial fibrillation is an important cause of embolic stroke of undetermined source, but the association between embolic stroke patterns, ESUS, and new AF diagnosis is unclear.
Do embolic stroke patterns on imaging predict ESUS etiology or a new diagnosis of atrial fibrillation in patients with ischemic stroke?
Observational (n=127)
Do embolic stroke patterns on imaging predict ESUS etiology or a new diagnosis of atrial fibrillation in patients with ischemic stroke?
Embolic stroke patterns on CT or MRI do not appear to be significantly associated with ESUS or a new diagnosis of atrial fibrillation.
Answers are grounded in this paper and cite their sources.
Embolic patterns should not guide ESUS or AF evaluation; leaves open need for validated imaging predictors in ischemic stroke.
Background. Atrial fibrillation (AF) is an important cause of embolic stroke of undetermined source (ESUS). Imaging-patterns like multiple infarcts, simultaneous involvement of different circulations, infarcts of different ages, and isolated cortical infarcts are likely to indicate cardioembolic stroke. The aim of our study was to evaluate the association between embolic stroke patterns, ESUS, and the new diagnosis of AF. Methods. Stroke etiology and imaging characteristics from patients included in the Find-AF study were obtained. Embolic stroke patterns in CT- or MR-imaging were correlated with the diagnosis of ESUS as well as the short- (on baseline ECG and during 7-day Holter) and long-term (12-month follow-up) diagnosis of AF. Results. From 281 patients included in the Find-AF study, 127 (45.2%) patients with ischemic lesions detected in CT or MRI were included. 26 (20.5%) of these patients had ESUS. At least one embolic stroke pattern was detected in 67 (52.7%) patients. Embolic stroke patterns were not associated with ESUS (OR 1.57, 0.65–3.79, p=0.317 ), the short-term (OR 0.64, 0.26–1.58, p=0.327 ) or long-term diagnosis of AF (OR 0.72, 0.31–1.68, p=0.448 ). Conclusions. This secondary data analysis of the Find-AF study could not provide evidence for an association between embolic stroke patterns, ESUS, and the new diagnosis of AF.
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Maier et al. (2017) conducted an observational in Ischemic stroke (n=127). Embolic stroke patterns on imaging vs. Absence of embolic stroke patterns was evaluated on Diagnosis of embolic stroke of undetermined source (ESUS) (OR 1.57, 95% CI 0.65-3.79, p=0.317). Embolic stroke patterns on imaging were not significantly associated with ESUS (OR 1.57; 95% CI 0.65-3.79; p=0.317) or the new diagnosis of atrial fibrillation.
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