ReviewJAMA neurology2019
Tailoring the Approach to Embolic Stroke of Undetermined Source: A Review.
Review in JAMA neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
57 citing papers in PubMed, 1 synthesis or guideline pooled it, 114 citations in OpenAlex.
- Assessment of Left Atrial Fibrosis by Cardiac Magnetic Resonance Imaging in Ischemic Stroke Patients Without Atrial Fibrillation: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2024Pooled it
- Hypertension With High-Risk Features in Cryptogenic Stroke: An Exploratory Analysis of the ARCADIA Randomized Clinical Trial.JAMA neurology · 2026Trial
- Atrial Cardiopathy and Nonstenosing Large Artery Plaque in Patients With Embolic Stroke of Undetermined Source.Stroke · 2020Trial
- Anticoagulation Treatment Response Among Phenotypic ESUS Clusters: Evidence From CASPR.Annals of clinical and translational neurology · 2026Article
- Incremental value of ultrasound-based carotid plaque-RADS beyond stenosis degree in discriminating symptomatic carotid atherosclerosis.Journal of ultrasound · 2026Article
- Optimal LDL-C Levels for Ischemic Stroke Prevention: A Neurologist's Perspective.Journal of lipid and atherosclerosis · 2026Review
- Sterile Vegetations in Malignancy: A Rare Case of Nonbacterial Thrombotic Endocarditis in a Patient with Metastatic Melanoma.Reports (MDPI) · 2026Article
- Atrial Cardiomyopathy Detected by Electrocardiogram: Association with Stroke in a Brazilian Electronic Cohort.Arquivos brasileiros de cardiologia · 2026Article
- Risk Factors for Adverse Outcomes in Cancer Patients With Sepsis.Journal of clinical medicine research · 2026Article
- Coronary atherosclerotic burden in patients with embolic stroke of undetermined source.European stroke journal · 2026Article
- Cardiac photon-counting detector computed tomography in acute ischemic stroke: diagnostic accuracy for detection of left atrial appendage thrombus.Therapeutic advances in neurological disorders · 2026Article
- Endothelial BMP6 Drives Hemodynamic-Dependent VSMCs Calcification in Carotid Atherosclerosis.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Cardioembolic stroke versus embolic stroke of undetermined source: early severity and long-term outcomes in a prospective cohort.BMC neurology · 2025Article
- Factor XI/XIa Inhibitors: Promising Agents for the Secondary Prevention of Ischemic StrokeBalkan medical journal · 2025Article
- Clarification of embolic source in ischaemic stroke by non-obstructive general angioscopy.Open heart · 2025Article
- The Importance of Timing in Performing a Holter ECG in Patients Diagnosed with an Embolic Stroke of Undetermined Source.Biomedicines · 2025Article
- Shifting Outcomes: Superior Functional Recovery in Embolic Stroke of Undetermined Source Compared to Cardioembolic Stroke.Neurology international · 2025Article
- Review
- Using clinical data to reclassify ESUS patients to large artery atherosclerotic or cardioembolic stroke mechanisms.Journal of neurology · 2024Article
- Prevalence, diagnosis and management of intracranial atherosclerosis in White populations: a narrative review.Neurological research and practice · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
Importance: One-third of ischemic strokes have no identifiable cause after standard evaluation. In 2014, researchers termed these embolic strokes of undetermined source (ESUS) and argued that this entity would respond to anticoagulation. Two recent randomized clinical trials have not upheld this hypothesis, leading to questions about the ESUS concept. Observations: This article proposes that ESUS remains a useful concept, the clinical effect of which can be enhanced by considering 2 subsets defined by their likelihood of responding to anticoagulation. Recent studies indicate that some ESUS cases result from subclinical atrial fibrillation, atrial cardiopathy, unrecognized myocardial infarction, patent foramen ovale, or cancer, while other cases result from nonstenosing large-artery atherosclerosis, aortic atherosclerosis, or nonatherosclerotic vasculopathies. Evidence suggests that anticoagulation will prove superior to antiplatelet therapy for cases in the first group of causative mechanisms but not those in the second group, suggesting the need for personalized therapy. Conclusions and Relevance: Although the ESUS concept as currently constructed cannot guide treatment, efforts to better understand ESUS and develop therapies tailored to specific mechanisms are likely to help reduce the burden of stroke.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.