US identifies patients at higher stroke risk

Using transcranial Doppler ultrasound to detect asymptomatic cerebral emboli can identify patients who are at a higher risk of stroke and transient ischemic attack as well as those with a low absolute stroke risk, according to an international study.

The technique might also be useful in selecting patients with asymptomatic carotid stenosis who are likely to benefit from endarterectomy.

Embolic signs-short-duration, high-energy signals-were present in 77 of 467 patients at baseline. The hazard ratio for the risk of ipsilateral stroke and transient ischemic attack from baseline to two years in patients with embolic signals compared with those without was 2.54. The hazard ratio for ipsilateral stroke alone was 5.57 (Lancet DOI:10.1016/S1474-4422(10)70120-4).

Absolute annual risk of ipsilateral stroke or a transient ischemic attack between baseline and two years was 7.13% in patients with embolic signals and 3.04% in those without. The absolute annual risk of ipsilateral stroke alone was 3.62% in patients with embolic signals and 0.7% in those without.