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Predictors of Recurrent Stroke After Embolic Stroke of Undetermined Source in the RE-SPECT ESUS Trial.

Publication ,  Journal Article
Del Brutto, VJ; Diener, H-C; Easton, JD; Granger, CB; Cronin, L; Kleine, E; Grauer, C; Brueckmann, M; Toyoda, K; Schellinger, PD; Lyrer, P ...
Published in: J Am Heart Assoc
June 7, 2022

Background We sought to determine recurrent stroke predictors among patients with embolic strokes of undetermined source (ESUS). Methods and Results We applied Cox proportional hazards models to identify clinical features associated with recurrent stroke among participants enrolled in RE-SPECT ESUS (Randomized, Double-Blind, Evaluation in Secondary Stroke Prevention Comparing the Efficacy and Safety of the Oral Thrombin Inhibitor Dabigatran Etexilate Versus Acetylsalicylic Acid in Patients With Embolic Stroke of Undetermined Source) trial, an international clinical trial evaluating dabigatran versus aspirin for patients with ESUS. During a median follow-up of 19 months, 384 of 5390 participants had recurrent stroke (annual rate, 4.5%). Multivariable models revealed that stroke or transient ischemic attack before the index event (hazard ratio [HR], 2.27 [95% CI, 1.83-2.82]), creatinine clearance <50 mL/min (HR, 1.69 [95% CI, 1.23-2.32]), male sex (HR, 1.60 [95% CI, 1.27-2.02]), and CHA2DS2-VASc ≥4 (HR, 1.55 [95% CI, 1.15-2.08] and HR, 1.66 [95% CI, 1.21-2.26] for scores of 4 and ≥5, respectively) versus CHA2DS2-VASc of 2 to 3, were independent predictors for recurrent stroke. Conclusions In RE-SPECT ESUS trial, expected risk factors previously linked to other common stroke causes were associated with stroke recurrence. These data help define high-risk groups for subsequent stroke that may be useful for clinicians and for researchers designing trials among patients with ESUS. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02239120.

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Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

June 7, 2022

Volume

11

Issue

11

Start / End Page

e023545

Location

England

Related Subject Headings

  • Tomography, Emission-Computed, Single-Photon
  • Stroke
  • Risk Factors
  • Male
  • Intracranial Embolism
  • Humans
  • Embolic Stroke
  • Dabigatran
  • Cerebral Infarction
  • Aspirin
 

Citation

APA
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Del Brutto, V. J., Diener, H.-C., Easton, J. D., Granger, C. B., Cronin, L., Kleine, E., … Sacco, R. L. (2022). Predictors of Recurrent Stroke After Embolic Stroke of Undetermined Source in the RE-SPECT ESUS Trial. J Am Heart Assoc, 11(11), e023545. https://doi.org/10.1161/JAHA.121.023545
Del Brutto, Victor J., Han-Christoph Diener, J Donald Easton, Christopher B. Granger, Lisa Cronin, Eva Kleine, Claudia Grauer, et al. “Predictors of Recurrent Stroke After Embolic Stroke of Undetermined Source in the RE-SPECT ESUS Trial.J Am Heart Assoc 11, no. 11 (June 7, 2022): e023545. https://doi.org/10.1161/JAHA.121.023545.
Del Brutto VJ, Diener H-C, Easton JD, Granger CB, Cronin L, Kleine E, et al. Predictors of Recurrent Stroke After Embolic Stroke of Undetermined Source in the RE-SPECT ESUS Trial. J Am Heart Assoc. 2022 Jun 7;11(11):e023545.
Del Brutto, Victor J., et al. “Predictors of Recurrent Stroke After Embolic Stroke of Undetermined Source in the RE-SPECT ESUS Trial.J Am Heart Assoc, vol. 11, no. 11, June 2022, p. e023545. Pubmed, doi:10.1161/JAHA.121.023545.
Del Brutto VJ, Diener H-C, Easton JD, Granger CB, Cronin L, Kleine E, Grauer C, Brueckmann M, Toyoda K, Schellinger PD, Lyrer P, Molina CA, Chutinet A, Bladin CF, Estol CJ, Sacco RL. Predictors of Recurrent Stroke After Embolic Stroke of Undetermined Source in the RE-SPECT ESUS Trial. J Am Heart Assoc. 2022 Jun 7;11(11):e023545.
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

June 7, 2022

Volume

11

Issue

11

Start / End Page

e023545

Location

England

Related Subject Headings

  • Tomography, Emission-Computed, Single-Photon
  • Stroke
  • Risk Factors
  • Male
  • Intracranial Embolism
  • Humans
  • Embolic Stroke
  • Dabigatran
  • Cerebral Infarction
  • Aspirin