title: "Cardioembolic profile" in patients with ischemic stroke: data from the analysis of 1037 cases.
abstract: BACKGROUND
  Basing on easily available clinical and instrumental data, we aimed to define an "atrial fibrillation profile" able to discriminate cases of stroke due to atrial fibrillation from cases due to atherothrombosis of large vessels or small-vessel disease.
  
  
  METHODS
  A total of 1037 consecutive patients with ischemic stroke were enrolled. Cases with undetermined stroke, rare causes, and cardioembolic sources of emboli other than atrial fibrillation were excluded from further analysis. Thus, 653 patients were evaluated, dividing them into 2 groups for comparison (164 with stroke due to atrial fibrillation and 489 with atherothrombotic/lacunar stroke). Clinical, echocardiography, and neuroradiologic data were considered to characterize such groups.
  
  
  RESULTS
  Atrial fibrillation and atherothrombotic-lacunar group presented a differential phenotypic profile. Binary multiple logistic regression identified age older than 75 years, female sex, left atrial dilation, cortical-subcortical cerebral index infarct, ischemic lesions in multiple vascular grounds, and spontaneous hemorrhagic transformation of brain infarction as significant predictors of cardioembolic stroke due to atrial fibrillation.
  
  
  CONCLUSIONS
  A simple profile, based on commonly available data, seems suitable to characterize patients with stroke due to atrial fibrillation. If further validated, it may be useful to identify patients with undetermined stroke (or other well-defined causes of stroke) at high risk of being affected by undetected subclinical paroxysmal atrial fibrillation, prompting further diagnostic work-up and with potential therapeutic implication.
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Chiti
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. Electronic address: nicola.L.giannini@gmail.com.
authors.forename: Nicola
authors.initials: N
authors.lastname: Giannini
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Eva
authors.initials: E
authors.lastname: Terni
authors.affiliation: Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Massimetti
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Gino
authors.initials: G
authors.lastname: Gialdini
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Mancuso
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Ubaldo
authors.initials: U
authors.lastname: Bonuccelli
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Orlandi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications*; D002545:Brain Ischemia / Q000209:etiology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000209:etiology*
keywords: Ischemic stroke; atherosclerosis; atrial fibrillation; cardioembolic predictors; lacunar infarcts