Sistema de Salut de Catalunya
Institut Català de la Salut
[Del Brutto VJ] Department of Neurology, University of Miami Miller School of Medicine, Miami, FL. [Diener HC] Department of Neurology, University DuisburgEssen, Essen, Germany. [Easton JD] Department of Neurology, University of California, San Francisco, CA. [Granger CB] Duke Clinical Research Institute, Durham, NC. [Cronin L] Boehringer Ingelheim Pharma, Burlington, Ontario, Canada. [Kleine E] Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany. [Molina CA] Unitat d’Ictus i Hemodinàmica Cerebral, Vall d’Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2023-01-10T08:05:50Z
2023-01-10T08:05:50Z
2022-06-07
Risk factors; Secondary prevention; Stroke predictors
Factores de riesgo; Prevención secundaria; Predictores de accidentes cerebrovasculares
Factors de risc; Prevenció secundària; Predictors d'accidents cerebrovasculars
Background We sought to determine recurrent stroke predictors among patients with embolic strokes of undetermined source (ESUS). Methods and Results We applied Cox proportional hazards models to identify clinical features associated with recurrent stroke among participants enrolled in RE‐SPECT ESUS (Randomized, Double‐Blind, Evaluation in Secondary Stroke Prevention Comparing the Efficacy and Safety of the Oral Thrombin Inhibitor Dabigatran Etexilate Versus Acetylsalicylic Acid in Patients With Embolic Stroke of Undetermined Source) trial, an international clinical trial evaluating dabigatran versus aspirin for patients with ESUS. During a median follow‐up of 19 months, 384 of 5390 participants had recurrent stroke (annual rate, 4.5%). Multivariable models revealed that stroke or transient ischemic attack before the index event (hazard ratio [HR], 2.27 [95% CI, 1.83–2.82]), creatinine clearance <50 mL/min (HR, 1.69 [95% CI, 1.23–2.32]), male sex (HR, 1.60 [95% CI, 1.27–2.02]), and CHA2DS2‐VASc ≥4 (HR, 1.55 [95% CI, 1.15–2.08] and HR, 1.66 [95% CI, 1.21–2.26] for scores of 4 and ≥5, respectively) versus CHA2DS2‐VASc of 2 to 3, were independent predictors for recurrent stroke. Conclusions In RE‐SPECT ESUS trial, expected risk factors previously linked to other common stroke causes were associated with stroke recurrence. These data help define high‐risk groups for subsequent stroke that may be useful for clinicians and for researchers designing trials among patients with ESUS.
This study was supported by Boehringer Ingelheim.
Article
Published version
English
Malalties cerebrovasculars - Factors de risc; Embòlia - Factors de risc; DISEASES::Cardiovascular Diseases::Vascular Diseases::Embolism and Thrombosis::Embolism; DISEASES::Cardiovascular Diseases::Vascular Diseases::Cerebrovascular Disorders::Stroke; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors; ENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::embolia y trombosis::embolia; ENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::trastornos cerebrovasculares::accidente cerebrovascular; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::estadística como asunto::probabilidad::riesgo::factores de riesgo
Wiley
Journal of the American Heart Association;11(11)
https://doi.org/10.1161/JAHA.121.023545
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
Articles científics - HVH [3440]
