Imperial College London
Alternate

ProfessorRolandVeltkamp

Faculty of Medicine, Department of Brain Sciences

Professor of Neurology and Chair of Stroke Medicine
 
 
 
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Contact

 

r.veltkamp

 
 
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Location

 

3 East6East WingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Veltkamp:2020:10.1001/jamaneurol.2020.1995,
author = {Veltkamp, R and Pearce, LA and Korompoki, E and Sharma, M and Kasner, SE and Toni, DS and Ameriso, SF and Mundl, H and Tatlisumak, T and Hankey, GJ and Lindgren, A and Berkowitz, SD and Arauz, A and Ozturk, S and Muir, KW and Chamorro, Á and Perera, K and Shuaib, A and Rudilosso, S and Shoamanesh, A and Connolly, SJ and Hart, RG},
doi = {10.1001/jamaneurol.2020.1995},
journal = {JAMA Neurology},
pages = {1233--1240},
title = {Characteristics of recurrent ischemic stroke after embolic stroke of undetermined source: secondary analysis of a randomized clinical trial.},
url = {http://dx.doi.org/10.1001/jamaneurol.2020.1995},
volume = {77},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Importance: The concept of embolic stroke of undetermined source (ESUS) unifies a subgroup of cryptogenic strokes based on neuroimaging, a defined minimum set of diagnostic tests, and exclusion of certain causes. Despite an annual stroke recurrence rate of 5%, little is known about the etiology underlying recurrent stroke after ESUS. Objective: To identify the stroke subtype of recurrent ischemic strokes after ESUS, to explore the interaction with treatment assignment in each category, and to examine the consistency of cerebral location of qualifying ESUS and recurrent ischemic stroke. Design, Setting, and Participants: The NAVIGATE-ESUS trial was a randomized clinical trial conducted from December 23, 2014, to October 5, 2017. The trial compared the efficacy and safety of rivaroxaban and aspirin in patients with recent ESUS (n = 7213). Ischemic stroke was validated in 309 of the 7213 patients by adjudicators blinded to treatment assignment and classified by local investigators into the categories ESUS or non-ESUS (ie, cardioembolic, atherosclerotic, lacunar, other determined cause, or insufficient testing). Five patients with recurrent strokes that could not be defined as ischemic or hemorrhagic in absence of neuroimaging or autopsy were excluded. Data for this secondary post hoc analysis were analyzed from March to June 2019. Interventions: Patients were randomly assigned to receive rivaroxaban, 15 mg/d, or aspirin, 100 mg/d. Main Outcomes and Measures: Association of recurrent ESUS with stroke characteristics. Results: A total of 309 patients (205 men [66%]; mean [SD] age, 68 [10] years) had ischemic stroke identified during the median follow-up of 11 (interquartile range [IQR], 12) months (annualized rate, 4.6%). Diagnostic testing was insufficient for etiological classification in 39 patients (13%). Of 270 classifiable ischemic strokes, 156 (58%) were ESUS and 114 (42%) were non-ESUS (37 [32%] cardioembolic, 26 [23%] atherosclerotic, 35 [31%] lacu
AU  - Veltkamp,R
AU  - Pearce,LA
AU  - Korompoki,E
AU  - Sharma,M
AU  - Kasner,SE
AU  - Toni,DS
AU  - Ameriso,SF
AU  - Mundl,H
AU  - Tatlisumak,T
AU  - Hankey,GJ
AU  - Lindgren,A
AU  - Berkowitz,SD
AU  - Arauz,A
AU  - Ozturk,S
AU  - Muir,KW
AU  - Chamorro,Á
AU  - Perera,K
AU  - Shuaib,A
AU  - Rudilosso,S
AU  - Shoamanesh,A
AU  - Connolly,SJ
AU  - Hart,RG
DO  - 10.1001/jamaneurol.2020.1995
EP  - 1240
PY  - 2020///
SN  - 2168-6149
SP  - 1233
TI  - Characteristics of recurrent ischemic stroke after embolic stroke of undetermined source: secondary analysis of a randomized clinical trial.
T2  - JAMA Neurology
UR  - http://dx.doi.org/10.1001/jamaneurol.2020.1995
UR  - https://www.ncbi.nlm.nih.gov/pubmed/32628266
UR  - https://jamanetwork.com/journals/jamaneurology/fullarticle/2767712
VL  - 77
ER  -
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