کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3060263 1187445 2013 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Should transesophageal echocardiography be performed in acute stroke patients with atrial fibrillation?
موضوعات مرتبط
علوم زیستی و بیوفناوری علم عصب شناسی عصب شناسی
پیش نمایش صفحه اول مقاله
Should transesophageal echocardiography be performed in acute stroke patients with atrial fibrillation?
چکیده انگلیسی

The diagnostic need for echocardiography in acute stroke patients with documented atrial fibrillation (AF) is controversial because the index stroke per se is an indication for therapeutic anticoagulation according to guidelines. We retrospectively analyzed medical records of 2390 stroke patients consecutively admitted over a 2-year period to three different stroke units at university hospitals in Berlin, Germany. AF was diagnosed in 21.2% (n = 506) of 2185 patients with acute ischemic stroke or transient ischemic attack. Overall, 36.6% (n = 185) of all AF patients underwent transesophageal echocardiography (TEE) or transthoracic echocardiography within days of hospital admission. According to multivariate analysis, age and in-hospital conventions determined the diagnostic use of TEE in stroke patients with known AF, while the existing cardiovascular risk profile had no impact. Major cardiac sources of embolism were identified by echocardiography in 9.7% (n = 18) of all AF patients with acute stroke, including non-AF-related sources of embolism in 3.8% (n = 7). However, echocardiographic findings did not result in any therapeutic intervention other than immediate anticoagulation. Furthermore, echocardiographic findings had no impact on the prescription of anticoagulants at hospital discharge or long-term survival. Taken together, our data indicate that diagnostic echocardiography offers only a little additional information and does not impact clinical management and outcome in acute stroke patients with known AF.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Clinical Neuroscience - Volume 20, Issue 4, April 2013, Pages 554–559
نویسندگان
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