Document Detail

Frequency and significance of cardiac sources of embolism in the TOAST classification.
MedLine Citation:
PMID:  17878729     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: This study was aimed at determining the frequency and coexistent patterns of high- and medium-risk cardiac sources of embolism (CSE) as defined by the Trial of ORG 10172 in the Acute Stroke Treatment (TOAST) classification system and at investigating how identified CSE contributed to this classification. METHODS: We analyzed data from 2,482 patients with acute cerebral infarctions who registered in the Yonsei Stroke Registry over a 10-year period. Cardiac sources were divided into high- and medium-risk groups based on the TOAST classification. RESULTS: Of the 2,482 patients, 1,130 (46%) underwent echocardiographic studies. At least one CSE was detected in 629 patients (25%). Atrial fibrillation was the most common high-risk CSE. Patent foramen ovale, spontaneous echo contrast and congestive heart failure comprised most of the medium-risk CSE. Atrial fibrillation frequently accompanied coexistent CSE (69%) such as spontaneous echo contrast, congestive heart failure, and left atrial/appendage thrombus, while patent foramen ovale was detected in isolation in more than 90% of the patients. Patients with a high-risk CSE were more likely to be diagnosed with cardioembolism (83%) than patients with only a medium-risk CSE (58%). CONCLUSIONS: Our study elucidated the frequency and various coexistent patterns of CSE in Korean stroke patients as defined by the TOAST classification system. In addition, we have demonstrated a higher correlation between high-risk CSE and cardioembolism than with medium-risk CSE and cardioembolism.
Sang Won Han; Hyo Suk Nam; Seo Hyun Kim; Jong Yun Lee; Kyung-Yul Lee; Ji Hoe Heo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-09-19
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  24     ISSN:  1015-9770     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2007  
Date Detail:
Created Date:  2007-10-25     Completed Date:  2007-12-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  463-8     Citation Subset:  IM    
Copyright Information:
(c) 2007 S. Karger AG, Basel
Department of Neurology, Sanggyepaik Hospital, Inje University College of Medicine, Seoul, Korea.
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MeSH Terms
Acute Disease
Aged, 80 and over
Atrial Fibrillation / complications
Cerebral Infarction / epidemiology,  etiology*,  ultrasonography
Embolism / complications*,  epidemiology,  etiology,  ultrasonography
Foramen Ovale, Patent / complications
Heart Diseases / classification,  complications*,  epidemiology,  ultrasonography
Heart Failure / complications
Korea / epidemiology
Middle Aged
Retrospective Studies
Risk Assessment
Risk Factors
Terminology as Topic

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