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Branch atheromatous disease diagnosed as embolic stroke of undetermined source: A sub-analysis of NAVIGATE ESUS

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dc.contributor.author Uchiyama, Shinichiro
dc.contributor.author Toyoda, Kazunori
dc.contributor.author Kitagawa, Kazuo
dc.contributor.author Okada, Yasushi
dc.contributor.author Ameriso, Sebastián Francisco
dc.contributor.author Mundl, Hardi
dc.contributor.author Berkowitz, Scott D.
dc.contributor.author Yamada, Takashi
dc.contributor.author Liu, Yan Yun
dc.contributor.author Hart, Robert G.
dc.contributor.author NAVIGATE ESUS Investigators
dc.date.accessioned 2020-12-09T13:16:46Z
dc.date.available 2020-12-09T13:16:46Z
dc.date.issued 2019-05-17
dc.identifier.citation Uchiyama, S., Toyoda, K., Kitagawa, K., Okada, Y., Ameriso, S., Mundl, H., Berkowitz, S., Yamada, T., Liu, Y.Y., Hart, R.G., NAVIGATE ESUS Investigators. Branch atheromatous disease diagnosed as embolic stroke of undetermined source: A sub-analysis of NAVIGATE ESUS. Int J Stroke 019 Dec;14(9):915-922. doi: 10.1177/1747493019852177. Epub 2019 May 27 en_US
dc.identifier.uri https://doi.org/10.1177/1747493019852177
dc.identifier.uri https://repositorio.fleni.org.ar/handle/123456789/254
dc.description.abstract Background: Branch atheromatous disease (BAD) is distinctive from large and small arterial diseases, which is single subcortical infarction larger than lacunar stroke in the territories of deep perforators without relevant arterial stenosis. BAD meets the current criteria of embolic stroke of undetermined source. We performed an exploratory analysis of BAD in patients recruited to NAVIGATE embolic stroke of undetermined source, a randomized controlled trial to compare rivaroxaban and aspirin in embolic stroke of undetermined source patients. Methods and results: Among 3972 stroke patients in cerebral hemispheres with intracranial arterial imaging, 502 (12.6%) patients met the criteria for BAD. BAD was associated with younger age (years; OR: 0.97, 95% CI: 0.96-0.98), race (Asian; OR: 1.78, 95% CI: 1.44-2.21), region (Eastern Europe; OR: 2.49, 95% CI: 1.87-3.32), and higher National Institute of Health Stroke Scale (OR: 1.17, 95% CI: 1.12-1.22) at randomization. During follow-up, stroke or systemic embolism (2.5%/year vs. 6.2%/year, p = 0.0022), stroke (2.1%/year vs. 6.2%/year, p = 0.0008), and ischemic stroke (2.1%/year vs. 5.9%/year, p = 0.0013) occurred less frequently in BAD than non-BAD patients. There were no differences in annual rates of stroke or systemic embolism (2.5%/year vs. 2.5%/year, HR: 1.01, 95% CI: 0.33-3.14) or major bleeding (1.3%/year vs. 0.8%/year, HR: 1.51, 95% CI: 0.25-9.05) between rivaroxaban and aspirin groups among BAD patients. Conclusions: BAD was relatively common, especially in Asian and from Eastern Europe among embolic stroke of undetermined source patients. Stroke severity was higher at randomization but recurrence of stroke was fewer in BAD than non-BAD patients. The efficacy and safety of rivaroxaban and aspirin did not differ among BAD patients. en_US
dc.language.iso eng en_US
dc.publisher Sage en_US
dc.rights info:eu-repo/semantics/openAccess
dc.rights.uri https://creativecommons.org/licenses/by/2.5/ar/
dc.subject Factor Xa Inhibitors en_US
dc.subject Inhibidores del Factor Xa en_US
dc.subject Intracranial Embolism en_US
dc.subject Embolia Intracraneal en_US
dc.subject Intracranial Hemorrhages en_US
dc.subject Hematoma Epidural Craneal en_US
dc.subject Cerebral Angiography en_US
dc.subject Angiografía Cerebral en_US
dc.subject Secondary Prevention en_US
dc.subject Prevención Secundaria en_US
dc.subject Stroke en_US
dc.subject Accidente Cerebrovascular en_US
dc.title Branch atheromatous disease diagnosed as embolic stroke of undetermined source: A sub-analysis of NAVIGATE ESUS en_US
dc.type info:eu-repo/semantics/publishedVersion
dc.type info:eu-repo/semantics/article en_US
dc.description.fil Fil: Uchiyama, Shinichiro. Sanno Hospital and Sanno Medical Center; Japón.
dc.description.fil Fil: Toyoda, Kazunori. National Cerebral and Cardiovascular Center; Japón.
dc.description.fil Fil: Kitagawa, Kazuo. Tokyo Women's Medical University; Japón.
dc.description.fil Fil: Okada, Yasushi. National Hospital Organization Kyushu Medical Center; Japón.
dc.description.fil Fil: Ameriso, Sebastián Francisco. Fil: Ameriso, Sebastián Francisco. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina.
dc.description.fil Fil: Mundl, Hardi. Bayer; Alemania.
dc.description.fil Fil: Berkowitz, Scott D. Bayer; Estados Unidos.
dc.description.fil Fil: Yamada, Takashi. Bayer, Japón.
dc.description.fil Fil: Liu, Yan Yun. Population Health Research Institute; Canadá.
dc.description.fil Fil: Hart, Robert G. Population Health Research Institute; Canadá.
dc.relation.ispartofVOLUME 14
dc.relation.ispartofNUMBER 9
dc.relation.ispartofPAGINATION 915-922
dc.relation.ispartofCOUNTRY Estados Unidos
dc.relation.ispartofCITY Thousand Oaks
dc.relation.ispartofTITLE International journal of stroke
dc.relation.ispartofISSN 1747-4949
dc.type.snrd info:ar-repo/semantics/artículo es_ES


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