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Abstract:
BACKGROUND AND AIMS:Patients with embolic strokes of undetermined source (ESUS) usually present with mild symptoms. We aimed to compare the baseline characteristics between mild and severe ESUS, identify predictors for severe ESUS, and assess outcomes of patients with severe ESUS. METHODS:In the AF-ESUS (AF-ESUS) dataset, we stratified ESUS severity using the median National Institutes of Health Stroke Scale (NIHSS) score on admission as cut-off. We performed multivariable stepwise regression analyses to identify independent predictors of severe ESUS and to assess the association between ESUS severity and stroke recurrence, death, and new incident atrial fibrillation (AF) on follow-up. The 10-year cumulative probabilities of outcome incidence were estimated by the Kaplan-Meier product limit method. RESULTS:In 772 patients (median NIHSS: 6 (interquartile range: 3-12)), 414 (53.6%) patients had severe ESUS (i.e. NIHSS ≥6). Female sex was the only independent predictor for severe ESUS (odds ratio: 1.72 (1.27-2.33)). The rates of recurrence (3.3%/year vs. 3.4%/year, adjusted-hazard ratio: 1.09 (0.73-1.62)) and new incident AF (13.5% vs. 17.0%, adjusted odds ratio: 0.67 (0.44-1.03)) were similar between severe and mild ESUS, but mortality was higher (5.4%/year vs. 3.7%/year, adjusted-hazard ratio: 1.51 (1.05-2.16)) in severe ESUS. The 10-year cumulative probability for stroke recurrence was similar between severe and mild ESUS (38.1% (29.2-48.6) vs. 36.6% (27.8-47.0), log-rank test: 0.01, p = 0.920). The 10-year cumulative probability of death was higher in patients with severe ESUS compared with mild ESUS (40.5% (32.5-50.0) vs. 34.0% (26.0-43.6) respectively; log-rank test: 4.54, p = 0.033). CONCLUSIONS:Women have more severe ESUS compared with men. Patients with severe ESUS have similar rates of stroke recurrence and new incident AF, but higher mortality compared with mild ESUS.
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最新影响因子:6.948 | 期刊ISSN:1747-4930 | CiteScore:2.9 |
出版周期:Quarterly | 是否OA:YES | 出版年份:2006 |
期刊官方网址:http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1747-4949
自引率:4.00% | 研究方向:医学-外周血管病 |
出版地区:ENGLAND |
SCI期刊coverage:Science Citation Index Expanded(科学引文索引扩展)
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国际中风杂志
大类(学科) | 小类(学科) | 学科排名 |
医学 |
CLINICAL NEUROLOGY (临床神经病学) 2区 PERIPHERAL VASCULAR DISEASE (外周血管病) 2区 |
44/197 13/65 |
年度总发文量 | 年度论文发表量 | 年度综述发表量 |
119 | 101 | 18 |
引文计数(2018)
文献(2015-2017)
2147次引用
740篇文献
序号 | 类别 | 排名 | 百分位 |
1 |
大类(学科):Neuroscience
小类(学科):Neurology
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