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Frequency and Patterns of Brain Infarction in Patients With Embolic Stroke of Undetermined Source: NAVIGATE ESUS Trial

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dc.contributor.author Sharma, Mukul
dc.contributor.author Smith, Eric E.
dc.contributor.author Pearce, Lesly A.
dc.contributor.author Shoamanesh, Ashkan
dc.contributor.author Perera, Kanjana S.
dc.contributor.author Coutts, Shelagh B.
dc.contributor.author Damgaard, Dorte
dc.contributor.author Ameriso, Sebastián Francisco
dc.contributor.author Rha, Joung-Ho
dc.contributor.author Modrau, Boris
dc.contributor.author Yoon, Byung-Woo
dc.contributor.author Romano, Marina
dc.contributor.author Messé, Steven R.
dc.contributor.author Barlinn, Jessica
dc.contributor.author Lambeck, Johann
dc.contributor.author Saad, Feryal
dc.contributor.author Berkowitz, Scott D.
dc.contributor.author Mundl, Hardi
dc.contributor.author Connolly, Stuart J.
dc.contributor.author NAVIGATE ESUS MIND MRI Substudy Investigators
dc.date.accessioned 2021-10-19T16:50:52Z
dc.date.available 2021-10-19T16:50:52Z
dc.date.issued 2021-09-20
dc.identifier.citation Sharma M, Smith EE, Pearce LA, Shoamanesh A, Perera KS, Coutts SB, Damgaard D, Ameriso SF, Rha JH, Modrau B, Yoon BW, Romano M, Messé SR, Barlinn J, Lambeck J, Saad F, Berkowitz SD, Mundl H, Connolly SJ, Hart RG; NAVIGATE ESUS MIND MRI Substudy Investigators. Frequency and Patterns of Brain Infarction in Patients With Embolic Stroke of Undetermined Source: NAVIGATE ESUS Trial. Stroke. 2021 Sep 20:STROKEAHA120032976. doi: 10.1161/STROKEAHA.120.032976 es_ES
dc.identifier.uri https://doi.org/10.1161/STROKEAHA.120.032976
dc.identifier.uri https://repositorio.fleni.org.ar/xmlui/handle/123456789/607
dc.description.abstract Background and purpose: The spectrum of brain infarction in patients with embolic stroke of undetermined source (ESUS) has not been well characterized. Our objective was to define the frequency and pattern of brain infarcts detected by magnetic resonance imaging (MRI) among patients with recent ESUS participating in a clinical trial. Methods: In the NAVIGATE ESUS trial (New Approach Rivaroxaban Inhibition of Factor Xa in a Global Trial Versus ASA to Prevent Embolism in Embolic Stroke of Undetermined Source), an MRI substudy was carried out at 87 sites in 15 countries. Participants underwent an MRI using a specified protocol near randomization. Images were interpreted centrally by those unaware of clinical characteristics. Results: Among the 918 substudy cohort participants, the mean age was 67 years and 60% were men with a median (interquartile range) of 64 (26-115) days between the qualifying ischemic stroke and MRI. On MRI, 855 (93%) had recent or chronic brain infarcts that were multiple in 646 (70%) and involved multiple arterial territories in 62% (401/646). Multiple brain infarcts were present in 68% (510/755) of those without a history of stroke or transient ischemic attack before the qualifying ESUS. Prior stroke/transient ischemic attack (P<0.001), modified Rankin Scale score >0 (P<0.001), and current tobacco use (P=0.01) were associated with multiple infarcts. Topographically, large and/or cortical infarcts were present in 89% (757/855) of patients with infarcts, while in 11% (98/855) infarcts were exclusively small and subcortical. Among those with multiple large and/or cortical infarcts, 57% (251/437) had one or more involving a different vascular territory from the qualifying ESUS. Conclusions: Most patients with ESUS, including those without prior clinical stroke or transient ischemic attack, had multiple large and/or cortical brain infarcts detected by MRI, reflecting a substantial burden of clinical stroke and covert brain infarction. Infarcts most frequently involved multiple vascular territories. es_ES
dc.language.iso eng es_ES
dc.publisher Lippincott Williams & Wilkins es_ES
dc.rights info:eu-repo/semantics/openAccess
dc.rights.uri https://creativecommons.org/licenses/by/2.5/ar/
dc.subject Brain Infarction es_ES
dc.subject Infarto Encefálico es_ES
dc.subject Embolic Stroke es_ES
dc.subject Accidente Cerebrovascular Embólico es_ES
dc.subject Magnetic Resonance Imaging es_ES
dc.subject Imagen por Resonancia Magnética es_ES
dc.subject Rivaroxaban es_ES
dc.subject Tobacco Use es_ES
dc.subject Uso de Tabaco es_ES
dc.title Frequency and Patterns of Brain Infarction in Patients With Embolic Stroke of Undetermined Source: NAVIGATE ESUS Trial es_ES
dc.type info:eu-repo/semantics/article es_ES
dc.type info:eu-repo/semantics/publishedVersion
dc.description.fil Fil: Sharma, Mukul. McMaster University; Canadá.
dc.description.fil Fil: Smith, Eric E. University of Calgary; Canadá.
dc.description.fil Fil: Pearce, Lesly A. St. Catharines; Canadá.
dc.description.fil Fil: Shoamanesh, Ashkan. McMaster University; Canadá.
dc.description.fil Fil: Perera, Kanjana S. McMaster University; Estados Unidos.
dc.description.fil Fil: Coutts, Shelagh B. University of Calgary; Canadá.
dc.description.fil Fil: Damgaard, Dorte. Aarhus University Hospital; Dinamarca.
dc.description.fil Fil: Ameriso, Sebastián Francisco. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina.
dc.description.fil Fil: Rha, Joung-Ho. Inha University Hospital; Corea del Sur.
dc.description.fil Fil: Modrau, Boris. Aalborg University Hospital; Dinamarca.
dc.description.fil Fil: Yoon, Byung-Woo. Seoul National University Hospital; Corea del Sur.
dc.description.fil Fil: Romano, Marina. Clinicas "Dr. N. Quirno"; Argentina.
dc.description.fil Fil: Messé, Steven R. University of Pennsylvania; Estados Unidos.
dc.description.fil Fil: Barlinn, Jessica. Technische Universitat Dresden; Alemania.
dc.description.fil Fil: Lambeck, Johann. Universitätsklinikum Freiburg; Alemania.
dc.description.fil Fil: Saad, Feryal. University of Calgary; Canadá.
dc.description.fil Fil: Berkowitz, Scott D. Bayer AG; Alemania.
dc.description.fil Fil: Mundl, Hardi. Bayer AG; Alemania.
dc.description.fil Fil: Connolly, Stuart J. Hamilton Health Sciences; Canadá.
dc.relation.ispartofCOUNTRY Estados Unidos
dc.relation.ispartofCITY Baltimore
dc.relation.ispartofTITLE Stroke
dc.relation.ispartofISSN 1524-4628
dc.type.snrd info:ar-repo/semantics/artículo es_ES


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