NEW YORK (Reuters Health), Dec 7 - Asymptomatic emboli detected by transcranial Doppler ultrasonography can predict stroke risk, according to a report in the December issue of Stroke.
Dr. Hugh S. Markus and Alice King from St. George's University of London, U.K., performed a systematic review and meta-analysis of 30 studies to identify whether ultrasound signals of emboli from different potential embolic sources are independent predictors of future stroke and transient ischemic attack (TIA) risk.
The presence of embolic signals predicted risk of both stroke alone and the combined end point of stroke/TIA in patients with acute stroke as well as those with symptomatic or asymptomatic carotid stenosis. The signals also predicted stroke in the immediate postoperative period after carotid endarterectomy, the authors report.
Embolic signals predicted future stroke/TIA in patients with middle cerebral artery stenosis, and stroke was significantly more frequent in patients with myocardial infarction or coronary artery bypass grafting who had embolic signals.
"This review provides strong evidence that embolic signals predict future ipsilateral stroke risk in patients with large artery disease, particularly symptomatic carotid stenosis," the authors conclude.
They add, "In these conditions embolic signals may be useful in risk stratification and in assessing therapeutic efficacy."
"For other embolic sources," the investigators say, "further prospective data are required."
Stroke 2009;40:3711-3717.
Last Updated: 2009-12-04 18:12:47 -0400 (Reuters Health)
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