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Poor Outcome of Stroke Patients With Atrial Fibrillation in the Presence of Coexisting Spontaneous Echo Contrast

Authors
 Joonsang Yoo  ;  Dongbeom Song  ;  Jang-Hyun Baek  ;  Young Dae Kim  ;  Hyo Suk Nam  ;  Geu-Ru Hong  ;  Jinkwon Kim  ;  Hye Sun Lee  ;  Ji Hoe Heo 
Citation
 Stroke, Vol.47(7) : 1920-1922, 2016 
Journal Title
 Stroke 
ISSN
 0039-2499 
Issue Date
2016
MeSH
Aged ; Aged, 80 and over ; Atrial Fibrillation/complications* ; Atrial Fibrillation/diagnostic imaging ; Brain Damage, Chronic/etiology ; Echocardiography, Transesophageal* ; Erythrocyte Aggregation* ; Female ; Fibrinolysis ; Humans ; Male ; Middle Aged ; Recovery of Function ; Retrospective Studies ; Severity of Illness Index ; Stroke/etiology* ; Thrombophilia/diagnostic imaging ; Thrombophilia/etiology ; Treatment Outcome
Keywords
atrial fibrillation ; cardioembolism ; ischemic stroke ; spontaneous echo contrast
Abstract
BACKGROUND AND PURPOSE: Spontaneous echo contrast (SEC) is frequently detected in patients with atrial fibrillation (AF). Coexisting SEC in patients with AF may be associated with heightened thrombogenicity, which affects stroke outcomes. METHODS: Consecutive stroke patients with nonvalvular AF who underwent transesophageal echocardiography were included in this study. We compared initial stroke severity and functional outcome at 3 months between the patients with and those without SEC. RESULTS: Of 440 patients with nonvalvular AF who underwent transesophageal echocardiography during a 7-year period, 193 (43.9%) patients had SEC. Stroke was more severe in the patients with SEC than in those without SEC (National Institute of Health Stroke Scale score: median [interquartile range], 5 [2-12] versus 3 [1-8]; P=0.004). The patients with SEC more frequently had poor functional outcomes (modified Rankin scale score of >2) at 3 months than those without SEC (32.3% versus 16.1%; P<0.001). On multivariate analysis, the presence of SEC was an independent factor of poor outcome (odds ratio, 2.09; 95% confidence interval, 1.24-3.53). CONCLUSIONS: In the ischemic stroke patients with nonvalvular AF, coexisting SEC was associated with more severe stroke and was predictive of poor long-term functional outcome.
Full Text
http://stroke.ahajournals.org/content/47/7/1920.long
DOI
10.1161/STROKEAHA.116.013351
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김영대(Kim, Young Dae) ORCID logo https://orcid.org/0000-0001-5750-2616
남효석(Nam, Hyo Suk) ORCID logo https://orcid.org/0000-0002-4415-3995
백장현(Baek, Jang Hyun)
송동범(Song, Dong Beom)
유준상(Yoo, Joon Sang)
이혜선(Lee, Hye Sun) ORCID logo https://orcid.org/0000-0001-6328-6948
허지회(Heo, Ji Hoe) ORCID logo https://orcid.org/0000-0001-9898-3321
홍그루(Hong, Geu Ru) ORCID logo https://orcid.org/0000-0003-4981-3304
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151729
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