Long-Term Outcomes of Ischemic Stroke of Undetermined Mechanism

A Population-Based Prospective Cohort

Negar Morovatdar, Amanda G. Thrift, Moira K. Kapral, Reza Behrouz, Hamidreza Saber, Amin Amiri, Mohammad Taghi Farzadfard, Naghmeh Mokhber, Saverio Stranges, Mahmoud Reza Azarpazhooh

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background and Purpose: Little is known about the short-and long-term outcomes of ischemic stroke of undetermined mechanism (ISUM). Methods: Subjects were recruited from the Mashhad Stroke Incidence Study. Ischemic stroke (IS) was classified on the basis of the TOAST criteria. We further categorized patients with ISUM into ISUMneg (negative clinical/test results for large artery, small artery) and ISUMinc (incomplete investigations). Cox proportional hazard models and the competing-risk regression model were used to compare 1 and 5 years mortality (all-causes) and recurrent rate among IS subtypes. Results: Overall, 1-year mortality was higher in those with ISUMinc than in ISUMneg (adjusted hazard ratio [aHR] 1.6, 95% CI 1.01-2.8; p = 0.04) and in other stroke subtypes. Cardioembolic stroke was associated with the greatest risk of stroke recurrence at one year (aHR 4.9, 95% CI 1.8-12.9; p = 0.001) and 5 years (HR 2.1, 95% CI 1.1-3.7; p = 0.01) as compared to ISUMneg. Conclusions: The classification of ISUM as a single group may lead to over-or underestimation of mortality and recurrence in this major category of IS. A better definition of ISUM is necessary to predict death and recurrence accurately.

Original languageEnglish (US)
Pages (from-to)160-164
Number of pages5
JournalNeuroepidemiology
Volume49
Issue number3-4
DOIs
StatePublished - Dec 1 2017

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Stroke
Population
Recurrence
Mortality
Arteries
Proportional Hazards Models
Cohort Studies

Keywords

  • Etiology
  • Prognosis and population-based studies
  • Stroke
  • Stroke of undetermined mechanism

ASJC Scopus subject areas

  • Epidemiology
  • Clinical Neurology

Cite this

Morovatdar, N., Thrift, A. G., Kapral, M. K., Behrouz, R., Saber, H., Amiri, A., ... Azarpazhooh, M. R. (2017). Long-Term Outcomes of Ischemic Stroke of Undetermined Mechanism: A Population-Based Prospective Cohort. Neuroepidemiology, 49(3-4), 160-164. https://doi.org/10.1159/000482019

Long-Term Outcomes of Ischemic Stroke of Undetermined Mechanism : A Population-Based Prospective Cohort. / Morovatdar, Negar; Thrift, Amanda G.; Kapral, Moira K.; Behrouz, Reza; Saber, Hamidreza; Amiri, Amin; Farzadfard, Mohammad Taghi; Mokhber, Naghmeh; Stranges, Saverio; Azarpazhooh, Mahmoud Reza.

In: Neuroepidemiology, Vol. 49, No. 3-4, 01.12.2017, p. 160-164.

Research output: Contribution to journalArticle

Morovatdar, N, Thrift, AG, Kapral, MK, Behrouz, R, Saber, H, Amiri, A, Farzadfard, MT, Mokhber, N, Stranges, S & Azarpazhooh, MR 2017, 'Long-Term Outcomes of Ischemic Stroke of Undetermined Mechanism: A Population-Based Prospective Cohort', Neuroepidemiology, vol. 49, no. 3-4, pp. 160-164. https://doi.org/10.1159/000482019
Morovatdar N, Thrift AG, Kapral MK, Behrouz R, Saber H, Amiri A et al. Long-Term Outcomes of Ischemic Stroke of Undetermined Mechanism: A Population-Based Prospective Cohort. Neuroepidemiology. 2017 Dec 1;49(3-4):160-164. https://doi.org/10.1159/000482019
Morovatdar, Negar ; Thrift, Amanda G. ; Kapral, Moira K. ; Behrouz, Reza ; Saber, Hamidreza ; Amiri, Amin ; Farzadfard, Mohammad Taghi ; Mokhber, Naghmeh ; Stranges, Saverio ; Azarpazhooh, Mahmoud Reza. / Long-Term Outcomes of Ischemic Stroke of Undetermined Mechanism : A Population-Based Prospective Cohort. In: Neuroepidemiology. 2017 ; Vol. 49, No. 3-4. pp. 160-164.
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