scholarly journals Etiology of ischemic stroke among young adults of Serbia

2008 ◽  
Vol 65 (11) ◽  
pp. 803-809 ◽  
Author(s):  
Dejana Jovanovic ◽  
Ljiljana Beslac-Bumbasirevic ◽  
Ranko Raicevic ◽  
Jasna Zidverc-Trajkovic ◽  
Marko Ercegovac
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Ischemic Stroke ◽  
Heart Diseases ◽  
Developed Countries ◽  
Large Artery ◽  
Stroke Treatment ◽  
Prosthetic Valves ◽  
Number Of Patients ◽  
Coagulation Inhibitors

Background/Aim. Etiology of ischemic stroke (IS) among young adults varies among countries. The aim of the study was to investigate the causes and risk factors of IS in the young adults of Serbia. Methods. A total of 865 patients with IS, aged 15 to 45 years, were treated throughout the period 1989-2005. Etiologic diagnostic tests were performed on the patient by the patient basis and according to their availability at the time of investigation. The most likely cause of stroke was categorized according to the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria. Results. There were 486 men and 379 women, with 19% of the patients ? 30 years old. Large artery arteriosclerosis and small artery disease were confirmed in 14% of the patients, and embolism and other determined causes in 20%. Undetermined causes made up 32% of the patients, mostly those (26%) with incomplete investigations. Smoking (37%), hypertension (35%) and hyperlipidemia (35%) were the most common risk factors. Rheumatic heart diseases and prosthetic valves were the most common causes of IS. Arterial dissections and coagulation inhibitors deficiency were detected in a small number of patients. Conclusion. Etiology of IS among Serbian young adults shares characteristics of those in both western and less developed countries.

Abstract 3884: Stroke Subtypes in Hispanic Patients in the NINDS Stroke Genetics Network (SiGN): A Comparison of Two Classification Systems

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Michael Katsnelson ◽  
Tatjana Rundek ◽  
Ralph Sacco ◽  
Hannah Gardener ◽  
Shaneela Malik ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Classification Systems ◽  
Blood Collection ◽  
Large Artery ◽  
Stroke Subtype ◽  
Reliable Determination ◽  
Stroke Treatment ◽  
Stroke Subtypes ◽  
Small Artery Occlusion

Objectives: Identification of gene variants of stroke subtypes is important for the development of tailored ischemic stroke therapies among various ethnic groups. Valid and reliable determination of ischemic stroke subtype is essential for achieving this goal and to standardize a classification scheme across multi-center studies and different populations. Causative Classification System for Ischemic Stroke (CCS) is a novel computerized subclassification tool developed to improve reliability and accuracy of classifying stroke types. The CCS algorithm relies on both phenotypic and causative stroke variables. A Hispanic subset of the SiGN, an important and distinct target population with greater risk of certain stroke subtypes, was evaluated with Trial of Org 10172 in Acute Stroke Treatment (TOAST) and CCS and the agreement between the two classification systems was analyzed. Methods: Over 6000 subjects at 15 sites across US and Europe were enrolled, with TOAST and CCS locally adjudicated. Blood collection and central data quality control (10% central readjudication) were performed on all participants. A subset of Hispanics was analyzed for the purpose of this study and the agreement between the TOAST and CCS were assessed by kappa statistic. Findings: Hispanics (n=595, 10.9%) compared to non-Hispanics (n=5457) were more likely to be younger (63.7 vs. 64.0), male (55% vs. 46%) and have fewer of the traditional stroke risk factors HTN (54% vs. 64%), Afib (11% vs. 14%), DM(23% vs. 25%), CAD(16% vs. 20%) and smoking(19% vs. 22%). While the TOAST showed no differences between stroke subtypes for Hispanic vs. non-Hispanics, in CCS, Hispanics were classified with more of large vessel (22% vs. 20%), cardioembolic (37% vs. 30%) and small vessel strokes (13% vs. 9%) and fewer with undetermined etiology (28% vs. 40%) as compared to non-Hispanics. TOAST and CCS offered moderate correlation across all stroke types in Hispanics: kappa of 0.66 for large artery atherosclerosis, 0.58 for cardioembolic, and 0.58 for small artery occlusion. Conclusion: CCS offers a more sensitive and accurate system for subphenotyping of strokes in Hispanics who tended to have relatively fewer risk factors and unclassified strokes. Further studies correlating the two classification systems and their relation to genotyping data are warranted.

scholarly journals Ischemic Stroke in Young Adults: Study of the Subtypes, Risk factors and Predictors of Poor Outcomes

2019 ◽  
Vol 16 (1) ◽  
pp. 29-34
Author(s):  
Reema Rajbhandari ◽  
Parmatma Prajuli ◽  
K K Oli
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Ischemic Stroke ◽  
Small Scale ◽  
Sudden Increase ◽  
Large Artery ◽  
Stroke Patients ◽  
Aggressive Approach ◽  
Positive Correlation ◽  
Poor Outcomes

The aim of this study is to show the subtype, risk factors and predictors of poor outcomes in young ischemic stroke patients. Materials and Methods: It is a prospective study where only young onset ischemic stroke patients are analyzed. 8% of total ischemic stroke sufferers were young adults; more prevalent in female (57.1%), with risk factors of smoking (47.6%) subtype cardio embolic (42.9%) was common. High NIHSS score was related to new event and correlation to mortality. Three month follow up showed MRS 2.86 ± 1.02. 57.1% of cases had significant disability (defined as MRS ≥ 3). There was a positive correlation of the cardio embolic subtype and the unclassified subtype to all three forms of poor outcomes, along with a positive correlation of the large artery atherothrombotic subtype to new events Recurrence of events (new stroke, sudden increase in symptoms and new TIAs) was observed in 14.3 %. Death was reported in 9.5% of cases.   Etiological diagnosis can be reached in majority of cases if an aggressive approach is maintained. This small scale study has provided an overview of the distribution of subtypes, risk factors and poor outcomes and their predictors. Cardiac diseases (esp. valvular disease) need to be taken more seriously to prevent cardio embolic strokes, while addressing other traditional risk factors to prevent the atherothrombotic subtypes.

scholarly journals Prevalence of the Antiphospholipid Antibodies in Young Adults with Ischemic Stroke

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4952-4952
Author(s):  
Antonella Vaccarino ◽  
Maria Pagliaro ◽  
Clara Rollone ◽  
Fabio Melis ◽  
Federica De Marco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Ischemic Stroke ◽  
Cardiovascular Risk ◽  
Ct Scan ◽  
Cardiovascular Risk Factors ◽  
Antiphospholipid Antibodies ◽  
Thrombotic Event ◽  
Ischemic Lesion ◽  
Number Of Patients

Background: Ischemic stroke is rare in young adults, with an incidence of about 10-15% of all the ischemic strokes. In about one third of these patients a cause is missing. Among patients with antiphospholipid antibodies syndrome (APS), stroke is the first thrombotic event in about 13% of cases. Aims of our project were: to evaluate the prevalence of antiphosfolipid antibodies (aPL),to investigate on the prevalence of conventional risk factors and to define the radiological characteristics of the ischemic lesion. Materials and methods: this is a no profit, observational multicenter prospective study. Inclusion criteria were: age older than 18 and younger than 55 years, informed written consent, a clinical and radiological diagnosis of stroke. Patient's data were collected at diagnosis and after 30 days from stroke. If any aPL positivity was found the patient was referred to our service to further/eventually confirm the diagnosis of APS. For each patient these data were collected: age, sex, body mass index, personal and familial history, concomitant co morbidities and therapies, cardiovascular risk factors, drug abuse. CT scan or angioCT or MRI was always performed at diagnosis, aPL profile was determined at diagnosis and eventually confirmed after 12 weeks according to the Sapporo criteria. None of the patients had a previous diagnosis of APS. Results: enrolled patients from January 2017 to December2018 were 46 out of 425 ischemic stroke (10.8%). We found 11/46 aPL positivity patients. Among these patients, 7 were confirmed at 12 weeks (15%). Baselines characteristics of the study population are detailed in table 1. We found a high prevalence of associated conventional cardiovascular risk factors: hypertension (56%), dyslipidemia ( 50%), obesity (55%), smoke ( 52%). We didn't find any correlation between APS and a clear radiological pattern on MRI and CT scan. Conclusions: Prevalence of APS was 15% in our cohort of young patients with stroke, 85% of which had an high risk aPL profile. The detection frequency is similar to the recent APS-ACTION and literature findings. In our cohort stroke was a relapse of a previous ischemic event in 24% of the patients, while in 15% there was a stroke's relapse. Even if these data should be confirmed with a wider number of patients, it seems to be useful to evaluate the presence of aPL in a young patient with ischemic stroke . Disclosures No relevant conflicts of interest to declare.

Risk Factors, Etiology, and Clinical Outcome of Ischemic Stroke in Young Adults Admitted in a Tertiary Care Hospital in India

2019 ◽  
Vol 2 (1) ◽  
pp. 32-39
Author(s):  
Madhavi Karri ◽  
Balakrishnan Ramasamy
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Tertiary Care ◽  
Care Hospital ◽  
Diagnostic Challenge ◽  
Stroke Treatment ◽  
Stroke In Young Adults ◽  
Stroke In Young

Background: Ischemic stroke in young adults is becoming a rising concern with the increase in vulnerability to traditional risk factors and changing lifestyles. Aim: An overview of risk factors, classification, and clinical outcome of ischemic stroke in young adults (19 to 45 years) has been presented. Methods: Data fulfilling the study criteria from the stroke registry between June 2014 and June 2017 were collected, and a detailed proforma was taken that included history, clinical examination, and routine investigations. Selective investigations such as prothrombotic workup and 24-hour Holter monitoring were performed. Stroke was subclassified using the Trial of Org 10172 in Acute Stroke Treatment criteria. National Institute of Health Stroke Scale (NIHSS) scores at baseline and the modified Rankin score (mRS) scoring after 3 months of patients’ admission were calculated. Results: Out of 223 identified cases of ischemic stroke in young adults, 186 (83.4%) were taken for analysis, constituting 7.3% of the total stroke population of 3,059. Among the cases taken for analysis, 137 were males and 49 were females. A total of 150 patients were among the age group of 36 to 45 years. Dyslipidemia, smoking, and alcohol consumption were prevalent in the study group. Atherosclerotic strokes were predominant in the study population. NIHSS scores at admission had a significant impact on mRS scores after 3 months. In this study, only 4% reported the recurrence of stroke, whereas mortality was about 0.02%. Conclusions: Workup required for ischemic stroke in young adults has always been a diagnostic challenge for physicians who treat the stroke patients, and this must be optimized in all health care centers. Despite extensive workup, 23.66% participants were found to be cryptogenic in this study. The clinical outcome was good in this study with less mortality observed.

scholarly journals Experiences of Thrombolytic Therapy for Ischemic Stroke in Tuzla Canton, Bosnia and Herzegovina

ISRN Stroke ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Dževdet Smajlović ◽  
Denisa Salihović ◽  
Omer Ć. Ibrahimagić ◽  
Zikrija Dostović ◽  
Leila Avdić ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Acute Ischemic Stroke ◽  
Bosnia And Herzegovina ◽  
Developed Countries ◽  
Stroke Severity ◽  
Large Artery ◽  
Stroke Risk Factor ◽  
Number Of Patients ◽  
The Mean

Aim. To demonstrate our experiences of thrombolytic therapy in acute ischemic stroke. Subjects and Methods. Patients with ischemic stroke treated with rt-PA, admitted at the Department of Neurology, Tuzla, Bosnia and Herzegovina, in the period between April 1, 2008, and December 31, 2012, were included. Results. Between April 2008 and December 2012, intravenous rt-PA was given to 87 patients with acute ischemic stroke, which represents 3.2% of patients with acute ischemic stroke admitted to our department in that period. Hypertension was the leading stroke risk factor. The mean NIHSS score before thrombolysis was 12 (range 4–21). Large artery arteriosclerosis was the most common stroke etiology. The mean door-to-needle time was 72 minutes and onset-to-needle time 152 minutes. Half of patients (44/87) had a significant improvement within the first 24 hours. Parenchymal hemorrhage occurred in 5 patients (6%) and was fatal in two cases. At 3-month follow-up, 45% of patients (39/87) had good outcome (mRS 0 or 1). Sixteen patients were dead at 3 months, and mean baseline stroke severity was significantly higher in patients who died (NIHSS 16.5 versus 11, P=0.003). Conclusion. The number of patients with acute ischemic stroke treated using rt-PA in the Department of Neurology, Tuzla, is lower than in developed countries. Thrombolytic therapy is safe and leads to favorable outcome in half of the patients.

scholarly journals Clinical Profile of Stroke Patients Presenting to the Emergency Department of a Major Stroke Centre in Oman

2021 ◽  
Author(s):  
Hasina A. Al Harthi ◽  
Ammar Al Kashmiri ◽  
Lubna M. Zakaryia ◽  
Jawad A. Al-Lawati ◽  
Omar M. Najem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Large Artery ◽  
Care Hospital ◽  
Stroke Patients ◽  
Vessel Occlusion ◽  
Number Of Patients

Objectives: Stroke is a significant public health problem and one of the important preventable non-communicable diseases. Preventive stroke programs are yet to be properly established in Oman, with a better focus on increasing awareness among those who are currently at risk. This study was conducted to describe the characteristics of stroke presenting to a tertiary care hospital in Oman. Methods: This was a cross-sectional hospital-based study. Included 193 stroke cases which were prospectively recruited from the Emergency Department of a tertiary-level hospital. Data was collected from November 2017 to April 2018. Results: The total number of patients was 193. 82.9% of strokes were ischemic strokes. 58% were male. The mean age of stroke patients was 61.05 years. Risk factors included hypertension (72.5%) and diabetes mellitus (54.4%). Dyslipidemia, atrial fibrillation and ischemic heart diseases were not particularly prevalent in our population. 24.4% of ischemic strokes had large artery atherosclerosis and 21.9% had small vessel occlusion. Significantly more patients had lower Glasgow Coma Scale (GCS), required ICU admission and had in-hospital deaths in hemorrhagic stroke compared to ischemic stroke. Conclusions: This study provides essential stroke characteristics data specific to Oman’s population. Most of the information obtained conforms with that described internationally and similar preventive strategies can be implemented. The information can be utilized by health administrators in planning resource allocation. Further research is needed to explore rehabilitation aspects and long-term outcomes. Keywords: Stroke; Ischemic; Hemorrhagic; Young Stroke; Risk Factors; Thrombolysis; Epidemiology; Oman.

scholarly journals Ischemic Stroke in the Very Old: The Lausanne Stroke Registry

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 365-365
Author(s):  
Gabriel R de Freitas ◽  
Virginija Gaigalaite ◽  
Guy van Melle ◽  
Gerald Devuyst ◽  
Julien Bogousslavsky
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Developed Countries ◽  
Large Artery ◽  
Short Term ◽  
Old Patients ◽  
Very Old ◽  
Stroke Registry ◽  
Poor Outcome ◽  
Artery Disease

P145 Background: Although the population of developed countries is changing and the very old represent the fastest-growing group, there are few studies on ischemic stroke in this age group. The aim of this study was to investigate characteristics of ischemic stroke in very old patients (VOP). Methods: We studied risk factors, etiology, clinical findings, lesion topography and short-term (one month) outcome in patients aged 80 years or older presenting with a first ever ischemic stroke compared to younger patients (YP), aged between 45 and 79 years. Logistic regression analysis was used to identify whether very old age was an independent predictor of poor outcome (mRS 4–6). Results: 452 patients (13%) were older than 80 years, and 2,889 (87%) between 45 and 79 years. There was a higher proportion of females in the VOP than in the YP (53% vs. 34%; P<0.001). The VOP group had lower frequencies for smoking (7% vs. 32%; P<0.001), hypercholesterolemia (16% vs. 27%; P<0.001) and an elevated hematocrit (12% vs. 19%; P<0.001). In contrast, a history of atrial fibrillation (23% vs. 9%; P<0.001) and coronary artery disease (30% vs. 22%; P<0.001) was more common in the VOP. Cardioembolic stroke was more frequent in the VOP (28% vs. 21%; P<0.001), whereas large artery disease was less frequent (18% vs. 24%; P<0.001). The frequency of small artery disease was comparable in the two groups. VOP more often presented an abrupt onset of symptoms (81% vs. 73%; P<0.001) and isolated Wernicke-type aphasia (4% vs. 1%; P<0.001), but a lower frequency of headache (7% vs. 14%; P<0.001). Except for a higher proportion of lesions in the left posterior superficial branch of the middle cerebral artery in VOP (9% vs. 6%; P=0.03), there was no difference in the cerebral territories involved. A poor outcome was more frequent in VOP than in YP (17% vs. 12%; P=0.003), but this was not seen after correction for confounding factors. Conclusions: Patients older than 80 years have different risk factors and stroke features compared with patients between 45 and 79 years. Although VOP have a poorer prognosis, age per se is not a predictor of short-term disability and death. Knowledge of these findings may improve stroke prevention and acute treatment in VOP.

scholarly journals Risk Factors and Etiologies of Ischemic Stroke in Young Adults: A Hospital-based Study in Bangladesh

2018 ◽  
Vol 8 (2) ◽  
pp. 138-144
Author(s):  
Rumana Habib ◽  
Ikram Hosen ◽  
Rashedul Islam ◽  
Nirmalendu Bikash Bhowmik
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Ischemic Stroke ◽  
Internal Capsule ◽  
Large Artery ◽  
Stroke Patients ◽  
Vessel Occlusion ◽  
Stroke In Young Adults ◽  
Subcortical Region ◽  
Associated Risk Factors

Background: Stroke is an important cause of disability among adults and is one of the leading causes of death worldwide. Strokes in young adults can have a significant impact on the affected individuals, their families and societies in general as the affected patients are in the economically productive period of their lives.This study was aimed to find out the demographic profile and explore the associated risk factors of the first-ever ischemic stroke of young adults.Methods: This retrospective study reviewed the records of 64 patients, age 18-49 years, ischemic stroke patients consecutively admitted in the Neurology department, BIRDEM General Hospital during the period January 2016 to June 2017. Study variables included hematological and biochemistry investigations and radiological and imaging findings. Stroke sub-typing was done following to TOAST criteria. Data of follow-up data at 3 month were also included. Data were expressed as number (percent) and managed by SPSS for Windows Version 15.Results: Of the 634 patients diagnosed as acute ischemic stroke 64 (9.90%) were in the 18-49 (yr) age range and the majority (55.4%) were male. Stroke was more common (47 out of 54) among the 31-49 years category as compare with the <30 years category. Stroke patients presented with diabetes mellitus(87.03%),arterial hypertension (44.4%), dyslipidemia (23.5%) and cigarette smoking (31.48%). Family history of stroke was present in 33.5% cases. Ten (6.51%) patients showed hypercoagualable state.Small vessel occlusion (SVO) found in 48.40% cases followed by large artery atherosclerosis (21.86%).Patients with SVO stroke presented with lacunar syndromes and lesions in Basal ganglia(12.1%),Thalamus(6.6%), Subcortical region (0.9%),Internal capsule (20.0%)and brain stem(11.3%). Thrombolysis was not done in any of patients. Most of the patients were on an anti-platelet treatment and majority (85.4%) receiving aspirin alone. Strokes left 48(75.5%)patients with moderate to moderately severe disability on discharge from the hospital.Mortality was lower (6.3%) and had good recovery 35 (54.6%).Conclusion: Ischemic stroke in the young adults accounted for 9.90% of the hospital admission with stroke. Those suffered from ischemic stroke had presence of modifiable risk factors. Predominance of SVO among them not only indicated stroke etiology but also predicted good short term prognosis.Birdem Med J 2018; 8(2): 138-144

scholarly journals In-hospital recurrence in a Chinese large cohort with acute ischemic stroke

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Fan Yu ◽  
Xiaolu Liu ◽  
Qiong Yang ◽  
Yu Fu ◽  
Dongsheng Fan
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Acute Ischemic Stroke ◽  
Recurrent Events ◽  
Early Stage ◽  
High Rate ◽  
Large Artery ◽  
Stroke Event

Abstract Acute ischemic stroke (AIS) has a high risk of recurrence, particularly in the early stage. The purpose of this study was to assess the frequency and risk factors of in-hospital recurrence in patients with AIS in China. A retrospective analysis was performed of all of the patients with new-onset AIS who were hospitalized in the past three years. Recurrence was defined as a new stroke event, with an interval between the primary and recurrent events greater than 24 hours; other potential causes of neurological deterioration were excluded. The risk factors for recurrence were analyzed using univariate and logistic regression analyses. A total of 1,021 patients were included in this study with a median length of stay of 14 days (interquartile range,11–18). In-hospital recurrence occurred in 58 cases (5.68%), primarily during the first five days of hospitalization. In-hospital recurrence significantly prolonged the hospital stay (P < 0.001), and the in-hospital mortality was also significantly increased (P = 0.006). The independent risk factors for in-hospital recurrence included large artery atherosclerosis, urinary or respiratory infection and abnormal blood glucose, whereas recurrence was less likely to occur in the patients with aphasia. Our study showed that the patients with AIS had a high rate of in-hospital recurrence, and the recurrence mainly occurred in the first five days of the hospital stay. In-hospital recurrence resulted in a prolonged hospital stay and a higher in-hospital mortality rate.

scholarly journals A Mendelian randomization analysis of the relationship between cardioembolic risk factors and ischemic stroke

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Danyang Tian ◽  
Linjing Zhang ◽  
Zhenhuang Zhuang ◽  
Tao Huang ◽  
Dongsheng Fan
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Mendelian Randomization ◽  
P Wave ◽  
Cardioembolic Stroke ◽  
Large Artery ◽  
Weighted Analysis ◽  
Inverse Variance ◽  
Weighted Median ◽  
Genetically Determined

AbstractObservational studies have shown that several risk factors are associated with cardioembolic stroke. However, whether such associations reflect causality remains unknown. We aimed to determine whether established and provisional cardioembolic risk factors are causally associated with cardioembolic stroke. Genetic instruments for atrial fibrillation (AF), myocardial infarction (MI), electrocardiogram (ECG) indices and N-terminal pro-brain natriuretic peptide (NT-pro BNP) were obtained from large genetic consortiums. Summarized data of ischemic stroke and its subtypes were extracted from the MEGASTROKE consortium. Causal estimates were calculated by applying inverse-variance weighted analysis, weighted median analysis, simple median analysis and Mendelian randomization (MR)-Egger regression. Genetically predicted AF was significantly associated with higher odds of ischemic stroke (odds ratio (OR): 1.20, 95% confidence intervals (CI): 1.16–1.24, P = 6.53 × 10–30) and cardioembolic stroke (OR: 1.95, 95% CI: 1.85–2.06, P = 8.81 × 10–125). Suggestive associations were found between genetically determined resting heart rate and higher odds of ischemic stroke (OR: 1.01, 95% CI: 1.00–1.02, P = 0.005), large-artery atherosclerotic stroke (OR: 1.02, 95% CI: 1.00–1.04, P = 0.026) and cardioembolic stroke (OR: 1.02, 95% CI: 1.00–1.04, P = 0.028). There was no causal association of P‐wave terminal force in the precordial lead V1 (PTFVI), P-wave duration (PWD), NT-pro BNP or PR interval with ischemic stroke or any subtype.

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