Key result
Young patients with ESUS face a ~15% long-term risk of recurrent stroke or TIA.
Why the study?
The pathophysiology of first-ever and recurrent stroke or TIA in young patients with embolic stroke or TIA of undetermined source (ESUS) remains unclear, requiring long-term follow-up studies to clarify the role of new-onset AF.
Cohort (n=108)
No
Answers are grounded in this paper and cite their sources.
In young patients (<=50 years) with ESUS followed for over a decade, recurrent stroke/TIA is relatively frequent (15% at 15 years) whereas new-onset clinical atrial fibrillation is low (5.5%), suggesting AF may not be a major underlying mechanism of ESUS in this younger demographic.
BACKGROUND: To date, the pathophysiology of first-ever and recurrent stroke/TIA still remains unclear in young patients with embolic stroke/TIA of undetermined source (ESUS). Clinical studies with long-term follow-up in young ESUS patients are necessary to investigate the underlying pathophysiology of first-ever and recurrent stroke/TIA in this patient population, in particular the role of new-onset atrial fibrillation. AIMS: Our aim was to study the long-term (>10-year) clinical outcome of young patients (<50 years) with ESUS. METHODS: This cohort study included all patients aged ≤ 50 years who underwent transoesophageal echocardiography for diagnostic work-up of ESUS during 1996-2008 from one tertiary center. All patients were contacted by telephone between September-November 2018 to update clinical information from medical records. The clinical outcomes of this study were incidence rates of all-cause and cardiovascular mortality, recurrent stroke/TIA, new-onset clinical AF, and ischemic vascular events. RESULTS: = 14 cardiovascular). The 15-year incidence rate of recurrent stroke/TIA was 15% (incidence rate = 1.09[95%CI 0.54-1.65]/100 patient-years) and a 5.5% incidence of new-onset clinical AF (incidence rate = 0.44[95%CI 0.09-0.79]/100 patient-years) following ESUS. CONCLUSIONS: The incidence of recurrent stroke/TIA is relatively high during long-term clinical follow-up of young patients with ESUS. In contrast, new-onset clinical AF is relatively low and therefore may not play an important part in the pathophysiology of first-ever and recurrent stroke/TIA of these patients.
No takes yet. Share an insight, caveat, or question.
Nassif et al. (2019) conducted a cohort in Embolic stroke/TIA of undetermined source (ESUS) (n=108). Embolic stroke/TIA of undetermined source (ESUS) at age <= 50 years was evaluated on Recurrent stroke/TIA (Incidence rate 1.21 per 100 patient-years, 95% CI 0.69-1.93). Young patients (<=50 years) with ESUS experienced a 15% cumulative incidence of recurrent stroke/TIA and a 5.5% incidence of new-onset clinical AF.
Synapse has enriched 10 related papers. Consider them for comparative context: