Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1186/s13089-020-0156-1 http://hdl.handle.net/11449/200068 |
Resumo: | Introduction: The presence of microembolic signals (MES) during the acute phase of stroke is poorly understood, and its role and clinical application in relation to risk stratification and prognosis in patients remain uncertain. We assessed the prevalence of spontaneous MES in acute stroke and their relationship with risk stratification, stroke recurrence, morbidity, and mortality. Patients and methods: This was a prospective cohort study conducted in the Stroke Unit. The MES presence was evaluated by transcranial Doppler (TCD) in patients with ischemic stroke within 48 h. The outcomes (risk stratification, morbidity, mortality, and recurrence of a stroke) were followed up for 6 months. The relationship between risk stratification and MES was obtained by odds ratios and that between MES and stroke recurrence, morbidity, and mortality using multiple logistic regression; considering statistical significance at P < 0.05. Results: Of the 111 patients studied, 70 were men (63.1%) and 90 were white (81.1%), with a median age of 68 years. The MES frequency was 7%. There was a significant relationship between MES and symptomatic carotid disease (OR = 22.7; 95% CI 4.1–125.7; P < 0.001), a shorter time to monitoring (OR = 12.4; 95% CI 1.4–105.4; P = 0.02), and stroke recurrence (OR = 16.83; 95% CI 2.01–141; P =.009). Discussion: It was observed that the stroke recurrence adjusted for prior stroke was higher and earlier among patients with MES detection. In conclusion, MES demonstrated a significant correlation with symptomatic carotid disease and a shorter DELAY until monitoring, and could be a predictor for the early recurrence of stroke in the long term. |
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Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective studyBrain embolismPrognosisRisk factorsStrokeTranscranial Doppler ultrasonographyIntroduction: The presence of microembolic signals (MES) during the acute phase of stroke is poorly understood, and its role and clinical application in relation to risk stratification and prognosis in patients remain uncertain. We assessed the prevalence of spontaneous MES in acute stroke and their relationship with risk stratification, stroke recurrence, morbidity, and mortality. Patients and methods: This was a prospective cohort study conducted in the Stroke Unit. The MES presence was evaluated by transcranial Doppler (TCD) in patients with ischemic stroke within 48 h. The outcomes (risk stratification, morbidity, mortality, and recurrence of a stroke) were followed up for 6 months. The relationship between risk stratification and MES was obtained by odds ratios and that between MES and stroke recurrence, morbidity, and mortality using multiple logistic regression; considering statistical significance at P < 0.05. Results: Of the 111 patients studied, 70 were men (63.1%) and 90 were white (81.1%), with a median age of 68 years. The MES frequency was 7%. There was a significant relationship between MES and symptomatic carotid disease (OR = 22.7; 95% CI 4.1–125.7; P < 0.001), a shorter time to monitoring (OR = 12.4; 95% CI 1.4–105.4; P = 0.02), and stroke recurrence (OR = 16.83; 95% CI 2.01–141; P =.009). Discussion: It was observed that the stroke recurrence adjusted for prior stroke was higher and earlier among patients with MES detection. In conclusion, MES demonstrated a significant correlation with symptomatic carotid disease and a shorter DELAY until monitoring, and could be a predictor for the early recurrence of stroke in the long term.Department of Neurology Psychology and Psychiatry Botucatu Medical School UNESP–Univ Estadual Paulista, Campus de Botucatu, Distrito de Rubião Jr, s/nDepartment of Applied Physical Therapy Institute of Health Sciences UFTM–Univ Federal do Triângulo MineiroDepartment of Internal Medicine Botucatu Medical School UNESP–Univ Estadual PaulistaDepartment of Tropical Diseases and Imaging Diagnosis Botucatu Medical School UNESP–Univ Estadual PaulistaDepartment of Surgery and Orthopedics Botucatu Medical School UNESP–Univ Estadual PaulistaDepartment of Neuroscience and Behavior Ribeirão Preto School of Medicine USP–Univ São PauloDepartment of Neurology Psychology and Psychiatry Botucatu Medical School UNESP–Univ Estadual Paulista, Campus de Botucatu, Distrito de Rubião Jr, s/nDepartment of Internal Medicine Botucatu Medical School UNESP–Univ Estadual PaulistaDepartment of Tropical Diseases and Imaging Diagnosis Botucatu Medical School UNESP–Univ Estadual PaulistaDepartment of Surgery and Orthopedics Botucatu Medical School UNESP–Univ Estadual PaulistaUniversidade Estadual Paulista (Unesp)UFTM–Univ Federal do Triângulo MineiroUniversidade de São Paulo (USP)Bazan, Rodrigo [UNESP]Luvizutto, Gustavo JoséBraga, Gabriel Pereira [UNESP]Bazan, Silméia Garcia Zanati [UNESP]Hueb, João Carlos [UNESP]de Freitas, Carlos Clayton Macedo [UNESP]Hamamoto Filho, Pedro Tadao [UNESP]Módolo, Gabriel Pinheiro [UNESP]Trindade, André Petean [UNESP]Sobreira, Marcone Lima [UNESP]Nunes, Hélio Rubens de Carvalho [UNESP]Leite, João PereiraPontes-Neto, Octávio Marques2020-12-12T01:56:44Z2020-12-12T01:56:44Z2020-12-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1186/s13089-020-0156-1Ultrasound Journal, v. 12, n. 1, 2020.2524-8987http://hdl.handle.net/11449/20006810.1186/s13089-020-0156-12-s2.0-85079451337Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengUltrasound Journalinfo:eu-repo/semantics/openAccess2024-08-16T15:45:53Zoai:repositorio.unesp.br:11449/200068Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-16T15:45:53Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study |
title |
Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study |
spellingShingle |
Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study Bazan, Rodrigo [UNESP] Brain embolism Prognosis Risk factors Stroke Transcranial Doppler ultrasonography |
title_short |
Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study |
title_full |
Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study |
title_fullStr |
Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study |
title_full_unstemmed |
Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study |
title_sort |
Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study |
author |
Bazan, Rodrigo [UNESP] |
author_facet |
Bazan, Rodrigo [UNESP] Luvizutto, Gustavo José Braga, Gabriel Pereira [UNESP] Bazan, Silméia Garcia Zanati [UNESP] Hueb, João Carlos [UNESP] de Freitas, Carlos Clayton Macedo [UNESP] Hamamoto Filho, Pedro Tadao [UNESP] Módolo, Gabriel Pinheiro [UNESP] Trindade, André Petean [UNESP] Sobreira, Marcone Lima [UNESP] Nunes, Hélio Rubens de Carvalho [UNESP] Leite, João Pereira Pontes-Neto, Octávio Marques |
author_role |
author |
author2 |
Luvizutto, Gustavo José Braga, Gabriel Pereira [UNESP] Bazan, Silméia Garcia Zanati [UNESP] Hueb, João Carlos [UNESP] de Freitas, Carlos Clayton Macedo [UNESP] Hamamoto Filho, Pedro Tadao [UNESP] Módolo, Gabriel Pinheiro [UNESP] Trindade, André Petean [UNESP] Sobreira, Marcone Lima [UNESP] Nunes, Hélio Rubens de Carvalho [UNESP] Leite, João Pereira Pontes-Neto, Octávio Marques |
author2_role |
author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Estadual Paulista (Unesp) UFTM–Univ Federal do Triângulo Mineiro Universidade de São Paulo (USP) |
dc.contributor.author.fl_str_mv |
Bazan, Rodrigo [UNESP] Luvizutto, Gustavo José Braga, Gabriel Pereira [UNESP] Bazan, Silméia Garcia Zanati [UNESP] Hueb, João Carlos [UNESP] de Freitas, Carlos Clayton Macedo [UNESP] Hamamoto Filho, Pedro Tadao [UNESP] Módolo, Gabriel Pinheiro [UNESP] Trindade, André Petean [UNESP] Sobreira, Marcone Lima [UNESP] Nunes, Hélio Rubens de Carvalho [UNESP] Leite, João Pereira Pontes-Neto, Octávio Marques |
dc.subject.por.fl_str_mv |
Brain embolism Prognosis Risk factors Stroke Transcranial Doppler ultrasonography |
topic |
Brain embolism Prognosis Risk factors Stroke Transcranial Doppler ultrasonography |
description |
Introduction: The presence of microembolic signals (MES) during the acute phase of stroke is poorly understood, and its role and clinical application in relation to risk stratification and prognosis in patients remain uncertain. We assessed the prevalence of spontaneous MES in acute stroke and their relationship with risk stratification, stroke recurrence, morbidity, and mortality. Patients and methods: This was a prospective cohort study conducted in the Stroke Unit. The MES presence was evaluated by transcranial Doppler (TCD) in patients with ischemic stroke within 48 h. The outcomes (risk stratification, morbidity, mortality, and recurrence of a stroke) were followed up for 6 months. The relationship between risk stratification and MES was obtained by odds ratios and that between MES and stroke recurrence, morbidity, and mortality using multiple logistic regression; considering statistical significance at P < 0.05. Results: Of the 111 patients studied, 70 were men (63.1%) and 90 were white (81.1%), with a median age of 68 years. The MES frequency was 7%. There was a significant relationship between MES and symptomatic carotid disease (OR = 22.7; 95% CI 4.1–125.7; P < 0.001), a shorter time to monitoring (OR = 12.4; 95% CI 1.4–105.4; P = 0.02), and stroke recurrence (OR = 16.83; 95% CI 2.01–141; P =.009). Discussion: It was observed that the stroke recurrence adjusted for prior stroke was higher and earlier among patients with MES detection. In conclusion, MES demonstrated a significant correlation with symptomatic carotid disease and a shorter DELAY until monitoring, and could be a predictor for the early recurrence of stroke in the long term. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-12-12T01:56:44Z 2020-12-12T01:56:44Z 2020-12-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1186/s13089-020-0156-1 Ultrasound Journal, v. 12, n. 1, 2020. 2524-8987 http://hdl.handle.net/11449/200068 10.1186/s13089-020-0156-1 2-s2.0-85079451337 |
url |
http://dx.doi.org/10.1186/s13089-020-0156-1 http://hdl.handle.net/11449/200068 |
identifier_str_mv |
Ultrasound Journal, v. 12, n. 1, 2020. 2524-8987 10.1186/s13089-020-0156-1 2-s2.0-85079451337 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Ultrasound Journal |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
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1808128163022110720 |