Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
    • Education
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
    • Education
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

Share

June 04, 2019; 92 (23) Article

Carotid plaques and detection of atrial fibrillation in embolic stroke of undetermined source

View ORCID ProfileGeorge Ntaios, Kalliopi Perlepe, Gaia Sirimarco, Davide Strambo, Ashraf Eskandari, Efstathia Karagkiozi, Anastasia Vemmou, Eleni Koroboki, Efstathios Manios, Konstantinos Makaritsis, Patrik Michel, Konstantinos Vemmos
First published May 8, 2019, DOI: https://doi.org/10.1212/WNL.0000000000007611
George Ntaios
From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for George Ntaios
Kalliopi Perlepe
From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gaia Sirimarco
From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Davide Strambo
From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ashraf Eskandari
From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Efstathia Karagkiozi
From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anastasia Vemmou
From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Eleni Koroboki
From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Efstathios Manios
From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Konstantinos Makaritsis
From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Patrik Michel
From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Konstantinos Vemmos
From the Department of Medicine (G.N., K.P., E.K., K.M.), Larissa University Hospital, School of Medicine, University of Thessaly, Greece; Stroke Center and Neurology Service, Department of Clinical Neurosciences (G.S., D.S., A.E., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Clinical Therapeutics (A.V., E.K., E.M., K.V.), Medical School of Athens, Alexandra Hospital; and Department of Neurology (E,K,), National and Kapodistrian University of Athens, Greece.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Short Form
Citation
Carotid plaques and detection of atrial fibrillation in embolic stroke of undetermined source
George Ntaios, Kalliopi Perlepe, Gaia Sirimarco, Davide Strambo, Ashraf Eskandari, Efstathia Karagkiozi, Anastasia Vemmou, Eleni Koroboki, Efstathios Manios, Konstantinos Makaritsis, Patrik Michel, Konstantinos Vemmos
Neurology Jun 2019, 92 (23) e2644-e2652; DOI: 10.1212/WNL.0000000000007611

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
565

Share

  • Article
  • Figures & Data
  • Info & Disclosures
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Objective To investigate the association between the presence of ipsilateral nonstenotic carotid plaques and the rate of detection of atrial fibrillation (AF) during follow-up in patients with embolic strokes of undetermined source (ESUS).

Methods We pooled data of all consecutive ESUS patients from 3 prospective stroke registries. Multivariate stepwise regression assessed the association between the presence of nonstenotic carotid plaques and AF detection. The 10-year cumulative probabilities of AF detection were estimated by the Kaplan-Meier product limit method.

Results Among 777 patients followed for 2,642 patient-years, 341 (38.6%) patients had an ipsilateral nonstenotic carotid plaque. AF was detected in 112 (14.4%) patients in the overall population during follow-up. The overall rate of AF detection was 8.5% in patients with nonstenotic carotid plaques (2.9% per 100 patient-years) and 19.0% in patients without (5.0% per 100 patient-years) (unadjusted hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.37–0.84). The presence of ipsilateral nonstenotic carotid plaques was associated with lower probability for AF detection (adjusted HR 0.57, 95% CI 0.34–0.96, p = 0.03). The 10-year cumulative probability of AF detection was lower in patients with ipsilateral nonstenotic carotid plaques compared to those without (34.5%, 95% CI 21.8–47.2 vs 49.0%, 95% CI 40.4–57.6 respectively, log-rank-test: 11.8, p = 0.001).

Conclusions AF is less frequently detected in ESUS patients with nonstenotic carotid plaques compared to those without.

Clinicaltrials.gov identifier NCT02766205.

Glossary

AF=
atrial fibrillation;
AHA=
American Heart Association;
CI=
confidence interval;
ESUS=
embolic stroke of undetermined source;
HR=
hazard ratio;
SCAF=
subclinical atrial fibrillation

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received October 1, 2018.
  • Accepted in final form February 1, 2019.
  • © 2019 American Academy of Neurology
View Full Text

AAN Members

We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.

Google Safari Microsoft Edge Firefox

Click here to login

AAN Non-Member Subscribers

Click here to login

Purchase access

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed.

Disputes & Debates: Rapid online correspondence

  • Author response: Carotid plaques and detection of atrial fibrillation in embolic stroke of undetermined source
    • George Ntaios, Internist / Stroke Physician, University of Thessaly, Larissa, Greece
    Submitted July 22, 2019
  • Author response: Carotid plaques and detection of atrial fibrillation in embolic stroke of undetermined source
    • George Ntaios, Internist / Stroke Physician, University of Thessaly, Larissa, Greece
    Submitted July 17, 2019
  • Reader response: Carotid plaques and detection of atrial fibrillation in embolic stroke of undetermined source
    • Simona Lattanzi, MD, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy.
    • Mauro Silvestrini, MD, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy.
    Submitted June 19, 2019
  • Reader response: Carotid plaques and detection of atrial fibrillation in embolic stroke of undetermined source
    • James E. Siegler, Physician, Hospital of the University of Pennsylvania
    • Jesse Thon, Physician, Hospital of the University of Pennsylvania
    • Brett L. Cucchiara, Physician, Hospital of the University of Pennsylvania
    Submitted June 06, 2019
Comment

REQUIREMENTS

If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • Glossary
    • Methods
    • Results
    • Discussion
    • Study funding
    • Disclosure
    • Appendix Authors
    • Footnotes
    • References
  • Figures & Data
  • Info & Disclosures
Advertisement

Related Articles

  • No related articles found.

Topics Discussed

  • Embolism
  • Cardiac

Alert Me

  • Alert me when eletters are published
Neurology: 99 (6)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • Neurology: Education
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2022 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise