{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T03:36:37Z","timestamp":1789011397833,"version":"build-2803163510"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>A new clinical construct termed embolic stroke of undetermined source (ESUS) was recently introduced, but no such population has been described yet. Our aim is to provide a detailed descriptive analysis of an ESUS population derived from a large prospective ischemic stroke registry using the proposed diagnostic criteria.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>The criteria proposed by the Cryptogenic Stroke\/ESUS International Working Group were applied to the Athens Stroke Registry to identify all ESUS patients. ESUS was defined as a radiologically confirmed nonlacunar brain infarct in the absence of (a) extracranial or intracranial atherosclerosis causing \u226550% luminal stenosis in arteries supplying the ischemic area, (b) major-risk cardioembolic source, and (c) any other specific cause of stroke.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>Among 2735 patients admitted between 1992 and 2011, 275 (10.0%) were classified as ESUS. In the majority of ESUS (74.2%), symptoms were maximal at onset. ESUS were of moderate severity (median National Institute Health Stroke Scale score, 5). The most prevalent risk factor was arterial hypertension (64.7%), and 50.9% of patients were dyslipidemic. Among potential causes of the ESUS, covert atrial fibrillation (AF) was the most prevalent: in 30 (10.9%) patients, AF was diagnosed during hospitalization for stroke recurrence, whereas in 50 (18.2%) patients AF was detected after repeated ECG monitoring during follow-up. Also, covert AF was strongly suggested in 38 patients (13.8%) but never recorded.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>About 10% of patients with first-ever ischemic stroke met criteria for ESUS; covert paroxysmal AF seems to be a frequent cause of ESUS.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.114.007240","type":"journal-article","created":{"date-parts":[[2014,11,7]],"date-time":"2014-11-07T10:17:57Z","timestamp":1415355477000},"page":"176-181","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":167,"title":["Embolic Strokes of Undetermined Source in the Athens Stroke Registry"],"prefix":"10.1161","volume":"46","author":[{"given":"George","family":"Ntaios","sequence":"first","affiliation":[{"name":"From the Department of Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Larissa, Greece (G.N., V.P., K.M.); Department of Medicine, Ioannina University Hospital, School of Medicine, University of Ioannina, Ioannina, Greece (H.M.); Department of Clinical Therapeutics, Medical School of Athens, Alexandra Hospital, Athens, Greece (E.M., K.V.); Department of Neurology, Eginition Hospital, University of Athens Medical School, Athens, Greece (K.S.); and Stroke Center,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasileios","family":"Papavasileiou","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Larissa, Greece (G.N., V.P., K.M.); Department of Medicine, Ioannina University Hospital, School of Medicine, University of Ioannina, Ioannina, Greece (H.M.); Department of Clinical Therapeutics, Medical School of Athens, Alexandra Hospital, Athens, Greece (E.M., K.V.); Department of Neurology, Eginition Hospital, University of Athens Medical School, Athens, Greece (K.S.); and Stroke Center,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haralambos","family":"Milionis","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Larissa, Greece (G.N., V.P., K.M.); Department of Medicine, Ioannina University Hospital, School of Medicine, University of Ioannina, Ioannina, Greece (H.M.); Department of Clinical Therapeutics, Medical School of Athens, Alexandra Hospital, Athens, Greece (E.M., K.V.); Department of Neurology, Eginition Hospital, University of Athens Medical School, Athens, Greece (K.S.); and Stroke Center,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Makaritsis","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Larissa, Greece (G.N., V.P., K.M.); Department of Medicine, Ioannina University Hospital, School of Medicine, University of Ioannina, Ioannina, Greece (H.M.); Department of Clinical Therapeutics, Medical School of Athens, Alexandra Hospital, Athens, Greece (E.M., K.V.); Department of Neurology, Eginition Hospital, University of Athens Medical School, Athens, Greece (K.S.); and Stroke Center,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efstathios","family":"Manios","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Larissa, Greece (G.N., V.P., K.M.); Department of Medicine, Ioannina University Hospital, School of Medicine, University of Ioannina, Ioannina, Greece (H.M.); Department of Clinical Therapeutics, Medical School of Athens, Alexandra Hospital, Athens, Greece (E.M., K.V.); Department of Neurology, Eginition Hospital, University of Athens Medical School, Athens, Greece (K.S.); and Stroke Center,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Spengos","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Larissa, Greece (G.N., V.P., K.M.); Department of Medicine, Ioannina University Hospital, School of Medicine, University of Ioannina, Ioannina, Greece (H.M.); Department of Clinical Therapeutics, Medical School of Athens, Alexandra Hospital, Athens, Greece (E.M., K.V.); Department of Neurology, Eginition Hospital, University of Athens Medical School, Athens, Greece (K.S.); and Stroke Center,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrik","family":"Michel","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Larissa, Greece (G.N., V.P., K.M.); Department of Medicine, Ioannina University Hospital, School of Medicine, University of Ioannina, Ioannina, Greece (H.M.); Department of Clinical Therapeutics, Medical School of Athens, Alexandra Hospital, Athens, Greece (E.M., K.V.); Department of Neurology, Eginition Hospital, University of Athens Medical School, Athens, Greece (K.S.); and Stroke Center,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Vemmos","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Larissa, Greece (G.N., V.P., K.M.); Department of Medicine, Ioannina University Hospital, School of Medicine, University of Ioannina, Ioannina, Greece (H.M.); Department of Clinical Therapeutics, Medical School of Athens, Alexandra Hospital, Athens, Greece (E.M., K.V.); Department of Neurology, Eginition Hospital, University of Athens Medical School, Athens, Greece (K.S.); and Stroke Center,..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1311376"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1313600"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70310-7"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000016042"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.20.7.864"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2009.02.003"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.19.2560"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.11.3160"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.106.25.3143"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejheart.2008.08.005"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.6.5.564"},{"key":"e_1_3_3_13_2","first-page":"541","article-title":"Experience from a multicentre stroke register: a preliminary report.","volume":"54","author":"Hatano S","year":"1976","unstructured":"Hatano S. Experience from a multicentre stroke register: a preliminary report. Bull World Health Organ. 1976;54:541\u2013553.","journal-title":"Bull World Health Organ"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.04.131"},{"key":"e_1_3_3_15_2","first-page":"261","volume":"37","author":"Diener HC","year":"2014","unstructured":"Diener HC, Connolly S, Easton J, Smith J, Duffy C, Bruckmann M. Rationale, objectives and design of a secondary stroke prevention study of dabigatran etexilate versus acetylsalicylic acid in patients with embolic stroke of undetermined source (RE-SPECT-ESUS). Cerebrovasc Dis. 2014; 37(suppl 1):261.","journal-title":"Rationale, objectives and design of a secondary stroke prevention study of dabigatran etexilate versus acetylsalicylic acid in patients with embolic stroke of undetermined source (RE-SPECT-ESUS). Cerebrovasc Dis."},{"key":"e_1_3_3_16_2","unstructured":"The NAVIGATE ESUS trial. Population Health Research Institute. http:\/\/www.phri.ca\/research\/stroke-cognition\/navigate-esus-111\/. Accessed October 12 2014."},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318259e221"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000145172.55640.93"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.22.2864"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1584"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318287281b"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.114.007240","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T17:50:28Z","timestamp":1717177828000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.114.007240"}},"subtitle":["A Descriptive Analysis"],"short-title":[],"issued":{"date-parts":[[2015,1]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,1]]}},"alternative-id":["10.1161\/STROKEAHA.114.007240"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.114.007240","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1]]},"assertion":[{"value":"2014-08-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-10-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-11-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}