| ORIGINAL ARTICLE |
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| Year : 2020 | Volume
: 9
| Issue : 1 | Page : 19-24 |
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Prevalence and major cardiac causes of cardio-embolic stroke and in-hospital mortality in Eastern Nepal
Rajesh Nepal MD, DM 1, Manoj Kumar Choudhary MD 1, Sahadev Dhungana MD, DM 1, Sushant Katwal MD 1, Sunil Babu Khanal MBBS 1, Madhav Bista MD 1, Abdul Khaliq Monib MD 1, Dilli Ram Kafle MD, DM 2
1 Department of Internal Medicine, Cardiology Unit, Nobel Medical College Teaching Hospital, Biratnagar, Nepal
2 Department of Internal Medicine, Neurology Unit, Nobel Medical College Teaching Hospital, Biratnagar, Nepal
Correspondence Address:
Dr. Rajesh Nepal
Department of Internal Medicine, Cardiology Unit, Nobel Medical College Teaching Hospital, Biratnagar
Nepal
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/JCPC.JCPC_57_19
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Background: Cardioembolism accounts for 15%–30% of all ischemic strokes. The study aims to assess conventional and major cardiac causes of cardio-embolic stroke, its prevalence, lesions associated with the side of weakness, and in-hospital mortality. Materials and Methods: Patients with cardio-embolic stroke over 18 months were included in the study. Groups were compared using Chi-square test and Student's t-test. Results: In 384 patients with ischemic stroke, 168 (44%) had a cardio-embolic stroke. Among these 168 cardio-embolic patients, 56% were male and 44% female with a mean age of 69 ± 1 year. Dyslipidemia (72%), hypertension (69%), smoking (34%), and diabetes (33%) were the most prevalent conventional cardiovascular risk factors in these patients. Atrial fibrillation (AF) (71%) was the most common specific cardiac cause for cardio-embolic stroke. Hypertension was present in more than 76%, while dyslipidemia in 66% of patients with AF. Seventeen patients (10%) had in-hospital mortality, while nine (5%) left the hospital against medical advice. The in-hospital mortality rates were not different in AF patients as compared to those with sinus rhythm (59% vs. 41%,P = 0.225). However, patients with left ventricular ejection fraction ≤50% had a higher rate of mortality when compared to patients with normal ejection fraction (P < 0.001). Patients with AF had a higher incidence of left-sided weakness when compared to sinus rhythm (P = 0.049). Conclusion: Hypertension and dyslipidemia were the most prevalent conventional risk factors, while AF was the most common cardiac cause of cardio-embolic stroke. Reduced left ventricular ejection fraction less than 50% was significant predictor of in-hospital mortality in cardio-embolic stroke patients.
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