Carotid plaques and detection of atrial fibrillation in embolic stroke of undetermined source.
Journal article

Carotid plaques and detection of atrial fibrillation in embolic stroke of undetermined source.

  • Ntaios G From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece. gntaios@med.uth.gr.
  • Perlepe K From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Sirimarco G From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Strambo D From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Eskandari A From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Karagkiozi E From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Vemmou A From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Koroboki E From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Manios E From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Makaritsis K From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Michel P From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Vemmos K From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
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  • 2019-05-10
Published in:
  • Neurology. - 2019
English OBJECTIVE
To investigate the association between the presence of ipsilateral nonstenotic carotid plaques and the rate of detection of atrial fibrillation (AF) during follow-up in patients with embolic strokes of undetermined source (ESUS).


METHODS
We pooled data of all consecutive ESUS patients from 3 prospective stroke registries. Multivariate stepwise regression assessed the association between the presence of nonstenotic carotid plaques and AF detection. The 10-year cumulative probabilities of AF detection were estimated by the Kaplan-Meier product limit method.


RESULTS
Among 777 patients followed for 2,642 patient-years, 341 (38.6%) patients had an ipsilateral nonstenotic carotid plaque. AF was detected in 112 (14.4%) patients in the overall population during follow-up. The overall rate of AF detection was 8.5% in patients with nonstenotic carotid plaques (2.9% per 100 patient-years) and 19.0% in patients without (5.0% per 100 patient-years) (unadjusted hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.37-0.84). The presence of ipsilateral nonstenotic carotid plaques was associated with lower probability for AF detection (adjusted HR 0.57, 95% CI 0.34-0.96, p = 0.03). The 10-year cumulative probability of AF detection was lower in patients with ipsilateral nonstenotic carotid plaques compared to those without (34.5%, 95% CI 21.8-47.2 vs 49.0%, 95% CI 40.4-57.6 respectively, log-rank-test: 11.8, p = 0.001).


CONCLUSIONS
AF is less frequently detected in ESUS patients with nonstenotic carotid plaques compared to those without.


CLINICALTRIALSGOV IDENTIFIER
NCT02766205.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/268733
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