Differential impact of unrecognised brain infarction on stroke outcome in non-valvular atrial fibrillation

Tae Jin Song, Jinkwon Kim, Hye Sun Lee, Chung Mo Nam, Hyo Seok Nam, Eun Hye Kim, Ki Jeong Lee, Dongbeom Song, Jihoe Heo, Young Dae Kim

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

There has been little information regarding the impact of unrecognised brain infarctions (UBIs) on stroke outcome in patients with non-valvular atrial fibrillation (NVAF). By using volumetric analysis of ischaemic lesions, we evaluated the potential impact of UBIs on clinical outcome according to their presence and categorised type. This study enrolled 631 patients with NVAF having no clinical stroke history. UBIs were categorised into three types as territorial, lacunar, or subcortical. We collected stroke severity, functional outcome at three months, and the total volume of UBIs and acute infarction lesions. We investigated the association between clinical outcome and the type or volume of UBI, using a linear mixed model and logistic regression analysis. UBIs were detected in 285 (45.2 %) patients; territorial UBIs were observed in 24.4 % of patients (154/631), lacunar UBIs in 25 % (158/631), and subcortical UBIs in 15.7 % (99/631). Although initial stroke severity was not different between patients with UBIs and those without, those with UBIs had less improvement during hospitalisation, leading to poorer outcome at three months. Among the three types of UBIs, only territorial UBIs were associated with poor outcome, especially in patients with relatively smaller acute infarction volume. UBIs, in particular, territorial UBIs, may be considered as predictors for poor outcome after ischaemic stroke in patients with NVAF. Our results suggest that the impact of UBIs on clinical outcome differs according to the type of UBIs and the acute stroke severity.

Original languageEnglish
Pages (from-to)1312-1318
Number of pages7
JournalThrombosis and Haemostasis
Volume112
Issue number6
DOIs
Publication statusPublished - 2014 Jan 1

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Brain Infarction
Atrial Fibrillation
Stroke
Infarction

All Science Journal Classification (ASJC) codes

  • Hematology

Cite this

Song, T. J., Kim, J., Lee, H. S., Nam, C. M., Nam, H. S., Kim, E. H., ... Kim, Y. D. (2014). Differential impact of unrecognised brain infarction on stroke outcome in non-valvular atrial fibrillation. Thrombosis and Haemostasis, 112(6), 1312-1318. https://doi.org/10.1160/TH14-02-0176
Song, Tae Jin ; Kim, Jinkwon ; Lee, Hye Sun ; Nam, Chung Mo ; Nam, Hyo Seok ; Kim, Eun Hye ; Lee, Ki Jeong ; Song, Dongbeom ; Heo, Jihoe ; Kim, Young Dae. / Differential impact of unrecognised brain infarction on stroke outcome in non-valvular atrial fibrillation. In: Thrombosis and Haemostasis. 2014 ; Vol. 112, No. 6. pp. 1312-1318.
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abstract = "There has been little information regarding the impact of unrecognised brain infarctions (UBIs) on stroke outcome in patients with non-valvular atrial fibrillation (NVAF). By using volumetric analysis of ischaemic lesions, we evaluated the potential impact of UBIs on clinical outcome according to their presence and categorised type. This study enrolled 631 patients with NVAF having no clinical stroke history. UBIs were categorised into three types as territorial, lacunar, or subcortical. We collected stroke severity, functional outcome at three months, and the total volume of UBIs and acute infarction lesions. We investigated the association between clinical outcome and the type or volume of UBI, using a linear mixed model and logistic regression analysis. UBIs were detected in 285 (45.2 {\%}) patients; territorial UBIs were observed in 24.4 {\%} of patients (154/631), lacunar UBIs in 25 {\%} (158/631), and subcortical UBIs in 15.7 {\%} (99/631). Although initial stroke severity was not different between patients with UBIs and those without, those with UBIs had less improvement during hospitalisation, leading to poorer outcome at three months. Among the three types of UBIs, only territorial UBIs were associated with poor outcome, especially in patients with relatively smaller acute infarction volume. UBIs, in particular, territorial UBIs, may be considered as predictors for poor outcome after ischaemic stroke in patients with NVAF. Our results suggest that the impact of UBIs on clinical outcome differs according to the type of UBIs and the acute stroke severity.",
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Song, TJ, Kim, J, Lee, HS, Nam, CM, Nam, HS, Kim, EH, Lee, KJ, Song, D, Heo, J & Kim, YD 2014, 'Differential impact of unrecognised brain infarction on stroke outcome in non-valvular atrial fibrillation', Thrombosis and Haemostasis, vol. 112, no. 6, pp. 1312-1318. https://doi.org/10.1160/TH14-02-0176

Differential impact of unrecognised brain infarction on stroke outcome in non-valvular atrial fibrillation. / Song, Tae Jin; Kim, Jinkwon; Lee, Hye Sun; Nam, Chung Mo; Nam, Hyo Seok; Kim, Eun Hye; Lee, Ki Jeong; Song, Dongbeom; Heo, Jihoe; Kim, Young Dae.

In: Thrombosis and Haemostasis, Vol. 112, No. 6, 01.01.2014, p. 1312-1318.

Research output: Contribution to journalArticle

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AU - Kim, Eun Hye

AU - Lee, Ki Jeong

AU - Song, Dongbeom

AU - Heo, Jihoe

AU - Kim, Young Dae

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