Cardioembolic Stroke Risk Predictors in Non-Lacunar Ischaemic Stroke

• Research type

  Research Study

• Full title

  Cardiac Abnormalities in Ischaemic Stroke Sub-types: Predictors of Cardioembolic Stroke Risk in Non-Lacunar Ischaemic Stroke

• IRAS ID

  180914

• Contact name

  Sheela Deepak Shah

• Contact email

  sheela.shah@meht.nhs.uk

• Sponsor organisation

  Mid Essex Hospital Services NHS Trust

• Clinicaltrials.gov Identifier

  IRAS Project ID 180914, IRAS

• Duration of Study in the UK

  1 years, 6 months, days

• Research summary

  TITLE:
  Cardiac abnormalities in different ischaemic stroke subtypes: Predictors of cardioembolic stroke risk in non-lacunar stroke

  AIM:
  To study the association of abnormal cardiac test results among different ischaemic stroke subtypes

  HYPOTHESIS:
  The subtype of non-lacunar ischaemic stroke is believed to be caused by cardioembilosm. A proven difference between the association of abnormal cardiac screening test results among non-lacunar stroke and lacunar stroke subgroups may be used to postulate that these abnormalities are predictive markers of cardioembolic stroke risk.

  BACKGROUND:
  Strokes occur in the brain due to sudden disruption of cerebral blood flow, either due to blockage by blood clots causing ischaemic strokes, or due to arterial rupture causing brain haemorrhage.

  Ischaemic strokes are caused either by platelet clots within small cerebral vessels causing “Lacunar Strokes” , or by blockage of larger arteries by fibrin clots transported from the heart, causing “Cardioembolic Strokes”. Cardioembolic Strokes occur often, causing more severe brain damage and poorer outcomes. Prevention with antiplatelet agents like aspirin is inefective, requiring anticoagulation therapy with drugs like Warfarin.

  Risk factors for ischaemic stroke are similar to cardiovascular disease, but Cardioembolic Strokes are caused by cardiac structural defects or arrhythmia due to Atrial Fibrillation. Cardioembolic screening tests sometimes miss these abnormalities. Atrial Fibrillation may be revealed by standard ECG tracings, Paroxysmal Atrial Fibrillation often being missed, warranting further interventional tests with greater resource implications.

  Hence, this study might help in identifying reliable markers of Cardioembolic stroke risk from the results of routine cardiac screening tests, that could help in improving stroke preventive strategies.

  METHOD:
  Retrosepective review of medical records of patients discharged with a primary diagnosis of Acute Stroke from MEHT between 1.1.2013 and 31.6.2015, including results of radiological and cardiac ECHO, Ambulatory and Standard 12-Lead ECG tests. Statistical regression analysis will be applied to the observed cardioembolic stroke risk variables among the ischaemic stroke subtypes.

• REC name

  South West - Cornwall & Plymouth Research Ethics Committee

• REC reference

  15/SW/0360

• Date of REC Opinion

  16 Dec 2015

• REC opinion

  Favourable Opinion