Evidence map›Paper›PMID 41327082›Full record

ArticleBMC neurology2025

Cardioembolic stroke versus embolic stroke of undetermined source: early severity and long-term outcomes in a prospective cohort.

Priyanka Boettger, Jamschid Sedighi, Martin Juenemann, Michael Buerke, Omar Alhaj Omar

Abstract readComparative Study
In one paragraph

Article in BMC neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Covert macrovascular disease and early outcome after ischemic cerebrovascular events.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Priyanka BoettgerDepartment of Cardiology, Angiology and Critical Care Medicine, Justus Liebig University, Klinikstrasse 33, Giessen, Hessen, 35392, Germany. Priyanka.boettger@uni-giessen.de.ORCID http://orcid.org/0009-0004-0534-132X
Jamschid SedighiDepartment of Cardiology, Angiology and Critical Care Medicine, Justus Liebig University, Klinikstrasse 33, Giessen, Hessen, 35392, Germany.ORCID http://orcid.org/0009-0007-9107-8063
Martin JuenemannDepartment of Neurology, Justus Liebig University, Klinikstrasse 33, Giessen, Hessen, 35392, Germany.ORCID http://orcid.org/0000-0002-8905-3138
Michael BuerkeDepartment of Cardiology, Angiology and Critical Care Medicine, St. Marien Hospital, Kampenstrasse 51, Siegen, Nord Rhine-Westphalia, 57072, Germany.ORCID http://orcid.org/0009-0009-5477-9957
Omar Alhaj OmarDepartment of Neurology, Justus Liebig University, Klinikstrasse 33, Giessen, Hessen, 35392, Germany.ORCID http://orcid.org/0009-0007-1932-4303

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEmbolic stroke of undetermined source (ESUS) constitutes a substantial proportion of ischemic strokes. Its distinction from cardioembolic stroke (CES) may carry prognostic implications. This study aimed to compare early and long-term outcomes between ESUS and CES.

methodsWe conducted a prospective cohort study of patients with ESUS and CES who underwent standardized diagnostic evaluation and prolonged cardiac monitoring. Stroke severity was assessed with the NIHSS, and functional outcome with the mRS at discharge, 30 days, and 12 months. ESUS patients were additionally evaluated for short-duration atrial fibrillation.

resultsDuring a 6-month prospective enrollment period, 771 patients with suspected stroke were screened, of whom 529 had ischemic stroke confirmed by neuroimaging. After applying ESUS criteria, 98 patients were classified as ESUS and 209 as CES (total study cohort, n = 307; 41% women; mean age 72 ± 9 years). Patients with ESUS presented with significantly lower stroke severity and achieved better functional outcomes than those with CES. The mean NIHSS score on admission was 6 (95% CI, 5-7) in the ESUS group and 11 (95% CI, 10-12) in the cardioembolic group ( p< 0.001). At discharge, the mean mRS score was 2.1 (95% CI, 1.8-2.4) for ESUS and 3.8 (95% CI, 3.5-4.1) for CES (p < 0.001). A favorable outcome (mRS 0-2) was more common in ESUS (68% vs. 34%; p < 0.001). In-hospital mortality occurred in 10.0% of cardioembolic patients and in none of the ESUS patients (p = 0.02). At 12 months, ESUS patients continued to show more favorable recovery, with higher rates of functional independence (60% vs. 28%; p < 0.001) and lower cumulative mortality (7.1% vs. 21.5%; p< 0.001).

conclusionsCompared with CES, ESUS was associated with less severe neurological deficits and more favorable outcomes, both early and at 12 months, including lower mortality and better functional recovery.

Indexed as

Embolic StrokeStrokeAgedAged, 80 and overAtrial FibrillationCohort StudiesFemaleHumansIschemic StrokeMaleMiddle AgedProspective StudiesSeverity of Illness IndexAtrial cardiopathyAtrial fibrillationCardioembolic strokeEmbolic stroke of undetermined sourceFunctional outcomeSex differencesStroke severity

Identifiers

PMID41327082
PMCPMC12701600

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.