Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study

Detalhes bibliográficos
Autor(a) principal: Bazan, Rodrigo [UNESP]
Data de Publicação: 2020
Outros Autores: 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
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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spelling 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)
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