Document Detail

Prevalence of embolic signals in acute coronary syndromes.
MedLine Citation:
PMID:  20044527     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: The purpose of this study was to assess the prevalence of embolic signals (ES) in acute coronary syndromes (ACS) and their association with stroke. METHODS: From December 2004 to October 2006, 209 consecutive patients with ACS (without prosthetic heart valves or previous stroke) were studied within 72 hours of symptom onset. Patients underwent ES monitoring in both middle cerebral arteries by transcranial Doppler for 30 minutes. Median follow-up was 14 months after discharge. RESULTS: Patients were treated according to current European Society Cardiology guidelines. Specifically, 92% of patients received heparin(s), 100% aspirin, 92% clopidogrel, 67% intravenous glycoprotein IIb/IIIa inhibitors, 9% fibrinolysis, and 67% underwent angioplasty. ES were detected in 7 patients (prevalence 3.4%; 95% CI, 1.4 to 6.8). Except for a higher prevalence of ES in patients with unstable angina versus other ACS categories (8.5% versus 1.9%, P=0.047), none of the factors among baseline characteristics, clinical features, ACS treatment, and cardiac findings were associated with the presence of ES. During hospitalization, 3 patients without ES had cerebrovascular events (one stroke and 2 transient ischemic attacks), whereas no cerebrovascular events occurred in patients with ES. CONCLUSIONS: The prevalence of ES among hospitalized patients with ACS is currently low, possibly because of improvement in ACS treatment. In this ACS sample, ES did not appear associated with short-term risk of cerebrovascular events.
Elena Meseguer; Julien Labreuche; Cloe Durdilly; Amaya Echeverr?a; Philippa C Lavallee; Gregory Ducrocq; Pierre-Jean Touboul; Philippe Gabriel Steg; Pierre Amarenco
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-12-31
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  41     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-26     Completed Date:  2010-02-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  261-6     Citation Subset:  IM    
INSERM U-698 and Paris-Diderot University, Bichat Hospital, Assistance Publique-Hopitaux de Paris, Paris, France.
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MeSH Terms
Acute Coronary Syndrome / drug therapy,  epidemiology*,  physiopathology
Angina, Unstable / drug therapy,  epidemiology,  physiopathology
Angioplasty, Transluminal, Percutaneous Coronary / statistics & numerical data
Anticoagulants / therapeutic use
Intracranial Embolism / epidemiology*,  prevention & control,  ultrasonography*
Middle Aged
Middle Cerebral Artery / physiopathology,  ultrasonography*
Platelet Aggregation Inhibitors / therapeutic use
Thrombolytic Therapy / statistics & numerical data
Ultrasonography, Doppler, Transcranial
Reg. No./Substance:
0/Anticoagulants; 0/Platelet Aggregation Inhibitors

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