{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T15:46:40Z","timestamp":1744818400825},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2018,12]]},"abstract":"\n Background and Purpose\u2014<\/jats:title>\n We aimed to assess if renal function can aid in risk stratification for ischemic stroke or transient ischemic attack (TIA) recurrence and death in patients with embolic stroke of undetermined source (ESUS).<\/jats:p>\n <\/jats:sec>\n \n Methods\u2014<\/jats:title>\n We pooled 12 ESUS datasets from Europe and America. Renal function was evaluated using the estimated glomerular filtration rate (eGFR) and analyzed in continuous, binary, and categorical way. Cox-regression analyses assessed if renal function was independently associated with the risk for ischemic stroke\/TIA recurrence and death. The Kaplan-Meier product limit method estimated the cumulative probability of ischemic stroke\/TIA recurrence and death.<\/jats:p>\n <\/jats:sec>\n \n Results\u2014<\/jats:title>\n \n In 1530 patients with ESUS followed for 3260 patient-years, there were 237 recurrences (15.9%) and 201 deaths (13.4%), corresponding to 7.3 ischemic stroke\/TIA recurrences and 5.6 deaths per 100 patient-years, respectively. Renal function was not associated with the risk for ischemic stroke\/TIA recurrence when forced into the final multivariate model, regardless if it was analyzed as continuous (hazard ratio, 1.00; 95% CI, 0.99\u20131.00 for every 1 mL\/min), binary (hazard ratio, 1.27; 95% CI, 0.87\u20131.73) or categorical covariate (likelihood-ratio test 2.59,\n P<\/jats:italic>\n =0.63 for stroke recurrence). The probability of ischemic stroke\/TIA recurrence across stages of renal function was 11.9% for eGFR \u226590, 16.6% for eGFR 60\u201389, 21.7% for eGFR 45\u201359, 19.2% for eGFR 30\u201344, and 24.9% for eGFR <30 (likelihood-ratio test 2.59,\n P<\/jats:italic>\n =0.63). The results were similar for the outcome of death.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions\u2014<\/jats:title>\n The present study is the largest pooled individual patient-level ESUS dataset, and does not provide evidence that renal function can be used to stratify the risk of ischemic stroke\/TIA recurrence or death in patients with ESUS.<\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/strokeaha.118.023281","type":"journal-article","created":{"date-parts":[[2018,12,26]],"date-time":"2018-12-26T15:07:11Z","timestamp":1545836831000},"page":"2904-2909","update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Renal Function and Risk Stratification of Patients With Embolic Stroke of Undetermined Source"],"prefix":"10.1161","volume":"49","author":[{"given":"George","family":"Ntaios","sequence":"first","affiliation":[{"name":"From the Department of Internal Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Greece (G.N, D.L., K.P., A.V., E.K., V.P.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory Y.H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University of Birmingham, United Kingdom (G.Y.H.L.)"},{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, United Kingdom (G.Y.H.L.)"},{"name":"Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Denmark (G.Y.H.L.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitris","family":"Lambrou","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Greece (G.N, D.L., K.P., A.V., E.K., V.P.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrik","family":"Michel","sequence":"additional","affiliation":[{"name":"Stroke Center, Lausanne University Hospital, Switzerland (P.M., K.P., A.E., S.N., G.S., D.S.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalliopi","family":"Perlepe","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Greece (G.N, D.L., K.P., A.V., E.K., V.P.)"},{"name":"Stroke Center, Lausanne University Hospital, Switzerland (P.M., K.P., A.E., S.N., G.S., D.S.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashraf","family":"Eskandari","sequence":"additional","affiliation":[{"name":"Stroke Center, Lausanne University Hospital, Switzerland (P.M., K.P., A.E., S.N., G.S., D.S.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Nannoni","sequence":"additional","affiliation":[{"name":"Stroke Center, Lausanne University Hospital, Switzerland (P.M., K.P., A.E., S.N., G.S., D.S.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaia","family":"Sirimarco","sequence":"additional","affiliation":[{"name":"Stroke Center, Lausanne University Hospital, Switzerland (P.M., K.P., A.E., S.N., G.S., D.S.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Strambo","sequence":"additional","affiliation":[{"name":"Stroke Center, Lausanne University Hospital, Switzerland (P.M., K.P., A.E., S.N., G.S., D.S.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Vemmos","sequence":"additional","affiliation":[{"name":"Hellenic Cardiovascular Research Society, Athens, Greece (K.V.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleni","family":"Koroboki","sequence":"additional","affiliation":[{"name":"First Department of Neurology, National and Kapodistrian University of Athens, Greece (E.K.)"},{"name":"Division of Brain Sciences, Department of Stroke Medicine, Imperial College, London, United Kingdom (E.K.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Efstathios","family":"Manios","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, Medical School of Athens, Alexandra Hospital, Athens, Greece (E.M.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasia","family":"Vemmou","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Greece (G.N, D.L., K.P., A.V., E.K., V.P.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Rodr\u00edguez-Campello","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, Hospital del Mar. Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d\u2019 Investigacions M\u00e8diques), Universitat Aut\u00f2noma de Barcelona, Spain (A.R.-C., E.C.-G., J.R.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Cuadrado-Godia","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, Hospital del Mar. Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d\u2019 Investigacions M\u00e8diques), Universitat Aut\u00f2noma de Barcelona, Spain (A.R.-C., E.C.-G., J.R.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaume","family":"Roquer","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, Hospital del Mar. Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d\u2019 Investigacions M\u00e8diques), Universitat Aut\u00f2noma de Barcelona, Spain (A.R.-C., E.C.-G., J.R.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Arnao","sequence":"additional","affiliation":[{"name":"Stroke Unit, University of Perugia, Italy (V.A., V.C., M.P.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeria","family":"Caso","sequence":"additional","affiliation":[{"name":"Stroke Unit, University of Perugia, Italy (V.A., V.C., M.P.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Paciaroni","sequence":"additional","affiliation":[{"name":"Stroke Unit, University of Perugia, Italy (V.A., V.C., M.P.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Exuperio","family":"Diez-Tejedor","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, La Paz University Hospital - Aut\u00f3noma University of Madrid, IdiPAZ Health Research Institute, Spain (E.D.-T., B.F., J.R.P.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blanca","family":"Fuentes","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, La Paz University Hospital - Aut\u00f3noma University of Madrid, IdiPAZ Health Research Institute, Spain (E.D.-T., B.F., J.R.P.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Rodr\u00edguez Pardo","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, La Paz University Hospital - Aut\u00f3noma University of Madrid, IdiPAZ Health Research Institute, Spain (E.D.-T., B.F., J.R.P.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Arauz","sequence":"additional","affiliation":[{"name":"Stroke Clinic, Instituto Nacional de Neurolog\u00eda y Neurocirug\u00eda Manuel Velasco Su\u00e1rez, Mexico City, Mexico (A.A.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian F.","family":"Ameriso","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute for Neurological Research, FLENI, Buenos Aires, Argentina (S.F.A., L.P., M.G.-S.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc\u00eda","family":"Pertierra","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute for Neurological Research, FLENI, Buenos Aires, Argentina (S.F.A., L.P., M.G.-S.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maia","family":"G\u00f3mez-Schneider","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute for Neurological Research, FLENI, Buenos Aires, Argentina (S.F.A., L.P., M.G.-S.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximiliano A.","family":"Hawkes","sequence":"additional","affiliation":[{"name":"Department of Neurology, Division of Critical Care Neurology, Mayo Clinic, Rochester, Minnesota (M.A.H.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Bandini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Chavarria Cano","sequence":"additional","affiliation":[{"name":"Department of Neurology, San Paolo Hospital, Savona, Italy (B.C.C., A.M.I.M., A.G.P., A.G.-N.)"},{"name":"Vascular Neurology Section, Stroke Center, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, IiSGM Health Research Institute, Universidad Complutense de Madrid, Spain (B.C.C., A.M.I.M., A.G.P., A.G.-N.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Maria Iglesias","family":"Mohedano","sequence":"additional","affiliation":[{"name":"Department of Neurology, San Paolo Hospital, Savona, Italy (B.C.C., A.M.I.M., A.G.P., A.G.-N.)"},{"name":"Vascular Neurology Section, Stroke Center, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, IiSGM Health Research Institute, Universidad Complutense de Madrid, Spain (B.C.C., A.M.I.M., A.G.P., A.G.-N.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9s","family":"Garc\u00eda Pastor","sequence":"additional","affiliation":[{"name":"Department of Neurology, San Paolo Hospital, Savona, Italy (B.C.C., A.M.I.M., A.G.P., A.G.-N.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Gil-N\u00fa\u00f1ez","sequence":"additional","affiliation":[{"name":"Department of Neurology, San Paolo Hospital, Savona, Italy (B.C.C., A.M.I.M., A.G.P., A.G.-N.)"},{"name":"Vascular Neurology Section, Stroke Center, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, IiSGM Health Research Institute, Universidad Complutense de Madrid, Spain (B.C.C., A.M.I.M., A.G.P., A.G.-N.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jukka","family":"Putaala","sequence":"additional","affiliation":[{"name":"Department of Neurology, Helsinki University Central Hospital and University of Helsinki, Finland (J.P., T.T.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Turgut","family":"Tatlisumak","sequence":"additional","affiliation":[{"name":"Department of Neurology, Helsinki University Central Hospital and University of Helsinki, Finland (J.P., T.T.)"},{"name":"Department of Clinical Neurosciences, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden (T.T.)"},{"name":"Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden (T.T.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel A.","family":"Barboza","sequence":"additional","affiliation":[{"name":"Neurosciences Department, Hospital Dr. Rafael A. 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