{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T03:53:38Z","timestamp":1775793218092,"version":"3.50.1"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["Ferreira, J. was funded by the FCT (UI\/BD\/150648\/2"],"award-info":[{"award-number":["Ferreira, J. was funded by the FCT (UI\/BD\/150648\/2"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["Ferreira, J. was funded by the FCT (UI\/BD\/150648\/2"],"award-info":[{"award-number":["Ferreira, J. was funded by the FCT (UI\/BD\/150648\/2"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>We investigated the burden of microembolic signals (MES) in patients with acute ischaemic stroke (AIS) and atrial fibrillation (AF), assessing their impact on functional outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods:<\/jats:title>\n                    <jats:p>This multicentre international prospective cohort study involved patients with AIS and either a known or newly diagnosed anticoagulant-na\u00efve AF. All centres utilised the same transcranial Doppler machine for 1-h monitoring with bilateral 2\u2009MHz probes within 24\u2009h of symptom onset. Recordings underwent MES analysis by a blinded central reader. The primary objectives were to ascertain the MES proportion and its association with functional outcomes assessed by the modified Rankin scale (mRS) score at 90\u2009days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Between September 2019 and May 2021, we enrolled 61 patients, with a median age of 78\u2009years (interquartile range 73\u201383) and a median stroke severity score of 11 (interquartile range 4\u201318). MES were observed in 14 patients (23%), predominantly unilateral (12\/14, 86%), with a median rate of 6 counts\/hour (interquartile range 4\u201318). MES occurrence was higher post-thrombectomy and among those with elevated brain natriuretic peptide levels (p\u2009&amp;lt;\u20090.05). A worse mRS score of 3\u20136 was more frequent in patients with MES, occurring in 11\/14 (79%), compared to those without MES, 20\/47 (43%), with an adjusted odds ratio of 5.04 (95% CI, 1.15\u201339.4), p\u2009=\u20090.04.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Nearly a quarter of patients with AIS and AF exhibited silent microembolization after the index event. Detecting MES within 24\u2009h post-stroke (using transcranial Doppler) could signify a marker of poor functional outcomes. Subsequent trials will assess if very early antithrombotic treatment might enhance outcomes in this highly selective group of cardioembolic stroke patients. (Clinicaltrials.gov ID: NCT06018090).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23969873231220508","type":"journal-article","created":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T06:31:17Z","timestamp":1703658677000},"page":"409-417","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Detection of microemboli in patients with acute ischaemic stroke and atrial fibrillation suggests poor functional outcome"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1401-2398","authenticated-orcid":false,"given":"Pedro","family":"Castro","sequence":"first","affiliation":[{"name":"Department of Neurology, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Faculty of Medicine of University of Porto, Porto, Portugal 1"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9286-8987","authenticated-orcid":false,"given":"J","family":"Ferreira","sequence":"additional","affiliation":[{"name":"UnIC@RISE, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal 2"}]},{"given":"Branko","family":"Malojcic","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Centre Zagreb, Zagreb, Croatia 3"}]},{"given":"Danira","family":"Bazadona","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Centre Zagreb, Zagreb, Croatia 3"}]},{"given":"Claudio","family":"Baracchini","sequence":"additional","affiliation":[{"name":"Stroke Unit and Neurosonology Laboratory, University of Padua School of Medicine, Padova. Italy 4"}]},{"given":"Alessio","family":"Pieroni","sequence":"additional","affiliation":[{"name":"Stroke Unit and Neurosonology Laboratory, University of Padua School of Medicine, Padova. Italy 4"}]},{"given":"David","family":"Skoloudik","sequence":"additional","affiliation":[{"name":"Center for Health Research, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic 5"}]},{"given":"Elsa","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Centro Hospitalar de S\u00e3o Jo\u00e3o, Faculty of Medicine of University of Porto, Portugal 6"}]},{"given":"Manfred","family":"Kaps","sequence":"additional","affiliation":[{"name":"Justus-Liebig-University Giessen, Giessen, Germany 7"}]}],"member":"286","published-online":{"date-parts":[[2024,6,1]]},"reference":[{"key":"2026012113102633600_bibr1-23969873231220508","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1111\/ene.12577","article-title":"Association of improved outcome in acute ischaemic stroke patients with atrial fibrillation who receive early antithrombotic therapy: analysis from VISTA","volume":"22","author":"Abdul-Rahim","year":"2015","journal-title":"Eur J Neurol"},{"key":"2026012113102633600_bibr2-23969873231220508","doi-asserted-by":"crossref","first-page":"2411","DOI":"10.1056\/NEJMoa2303048","article-title":"Early versus later anticoagulation for stroke with atrial fibrillation","volume":"388","author":"Fischer","year":"2023","journal-title":"N Engl J Med"},{"key":"2026012113102633600_bibr3-23969873231220508","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1161\/STROKEAHA.116.013133","article-title":"Carotid atherosclerosis and stroke in atrial fibrillation","volume":"47","author":"Bekwelem","year":"2016","journal-title":"Stroke"},{"key":"2026012113102633600_bibr4-23969873231220508","doi-asserted-by":"crossref","first-page":"20230216","DOI":"10.3390\/ijerph20043491","article-title":"Long-term outcomes after stroke in patients with atrial fibrillation: a single center study","volume":"20","author":"Tracz","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"2026012113102633600_bibr5-23969873231220508","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1177\/23969873231177625","article-title":"The risk of stroke recurrence in patients with atrial fibrillation and reduced ejection fraction","volume":"8","author":"RAF and RENO-EXTEND Investigators","year":"2023","journal-title":"Eur Stroke J"},{"key":"2026012113102633600_bibr6-23969873231220508","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2021.685821","article-title":"Admission and readmission\/death patterns in hospitalized and non-hospitalized first-ever-in-a-lifetime stroke patients during the first year: a population-based incidence study","volume":"12","author":"Abreu","year":"2021","journal-title":"Front Neurol"},{"key":"2026012113102633600_bibr7-23969873231220508","doi-asserted-by":"crossref","first-page":"2538","DOI":"10.1161\/STROKEAHA.121.038155","article-title":"Long-term survival, stroke recurrence, and life expectancy after an acute stroke in Australia and New Zealand from 2008-2017: a population-wide cohort study","volume":"53","author":"Peng","year":"2022","journal-title":"Stroke"},{"key":"2026012113102633600_bibr8-23969873231220508","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1161\/01.STR.29.3.725","article-title":"Consensus on microembolus detection by TCD. 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