%0 Journal Article
%T Cardioembolic Sources in Stroke Patients in South of Brazil
%A Luiz Carlos Porcello Marrone
%A Jo£¿o Pedro Farina Brunelli
%A Ricardo Lutzky Saute
%A Gustavo Henrique Tomasi
%A Bianca Cecchele Madeira
%A William Alves Martins
%A Robson Dupont Rohr
%A Ana Paula Heck
%A Luiz Ricardo Botton
%A Marilia Martins de Castro
%A Rodrigo Bodanese
%A Luiz Carlos Bodanese
%A Ant£¿nio Carlos Huf Marrone
%A Jaderson Costa da Costa
%J Thrombosis
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/753780
%X Background. Stroke is a leading cause of mortality and disability in Brazil and around the world. Cardioembolism is responsible for nearly 30% of the origins of ischemic stroke. Methods. We analyzed data of 256 patients with cardioembolic ischemic stroke (according to TOAST classification) who were admitted into the Hospital S£¿o Lucas-PUCRS from October 2011 to January 2014. The cardioembolic subtype was divided into six subgroups: arrhythmias, valvular heart disease, coronary artery disease, cardiomyopathy, septal abnormalities, and intracardiac injuries. The prevalence of the most important cardiovascular risk factors and medications in use for prevention of systemic embolism by the time of hospital admission was analyzed in each patient. Results. Among 256 patients aged 60.2 +/£¿ 6.9 years, 132 males, arrhythmias were the most common cause of cardioembolism corresponding to 50.7%, followed by valvular heart disease (17.5%) and coronary artery disease (16%). Hypertension (61.7%) and dyslipidemia (43.7%) were the most common risk factors. Less than 50% of patients with arrhythmias were using oral anticoagulants. Conclusions. Identifying the prevalence of cardioembolic stroke sources subgroups has become an increasingly important role since the introduction of new oral anticoagulants. In this study, arrhythmias (especially atrial fibrillation) were the main cause of cardioembolism. 1. Introduction Stroke is the leading cause of mortality and disability in Brazil and South America. However, there is little knowledge about stroke epidemiology, stroke subtypes, and risk factors in Latin America [1¨C3]. Basically strokes can be divided into ischemic (85%) and hemorrhagic (15%). The clinical characteristics of stroke vary according to etiology and risk factors. To facilitate and standardize the classification of stroke subtypes, it was developed in 1993¡ªthe TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification which divides the ischemic stroke into five subtypes: large-artery atherosclerosis, cardioembolism, small-vessel occlusion, stroke of other determined etiology, and stroke of undetermined etiology. Knowledge of the etiology of ischemic events is essential for correct treatment and secondary prevention to improve the best patient outcomes [4, 5]. In the south of Brazil, the most important source of ischemic stroke is large-artery atherosclerosis followed by cardioembolism and small-vessel disease. Cardioembolism is responsible for nearly 30% of the origins of ischemic stroke [2, 6, 7]. Cardioembolism can be subdivided into six subgroups:
%U http://www.hindawi.com/journals/thrombosis/2014/753780/