The Athens Stroke Registry: Results of a five-year hospital-based study

The advent and wide application of new technology, especially noninvasive t echniques, has enabled physicians to more completely investigate and clarif y the etiopathogenic mechanisms of stroke. Such data have not been availabl e until recently for Southeastern Europe. In addition, during the last deca des, strategies for the modification of risk factors and primary prevention may have changed the prevalence of each subgroup of stroke as well. We inv estigated 1,042 consecutive patients who had first strokes, during a period of 5 years (from June 1992 to May 1997) and classified them prospectively based on etiopathogenic mechanisms. Patients with transient ischemic attack s and subarachnoid hemorrhage were excluded. There were 613 male and 429 fe male patients, with a mean age of 70.2 +/- 11.9 years. Forty-six percent of the patients arrived within 3 h from stroke onset. The probable mechanisms were: large-artery atherosclerosis, 156 (15%); lacunes, 177 (17%); cardioe mbolic, 335 (32.1%); infarct of unknown cause, 182 (17.5%); miscellaneous c auses, 35 (3.3%), and intracerebral hemorrhage (ICH), 157 (15.1%). In the c ardioembolic group, nonvalvular atrial fibrillation (NVAF) was the probable cause in 225 patients, especially in patients older than 75 years (65%). T he overall hospital mortality was 15.2% (from 0.6% for lacunar stroke to 34 % for ICH). In our population, cardioembolism is the most frequent subtype of stroke. NVAF is the most likely source, especially in older patients. Co pyright (C) 2000 S. Karger AG, Basel.