Cryptogenic stroke is a significant clinical problem

Cryptogenic Stroke

Overview

Stroke is the third leading cause of death worldwide with 20M annual events. In the US, each year there are 800K strokes, of which 195K are recurrent (Figure).   Additionally, there are over 500K Transient Ischemic Attacks (TIAS), or “mini strokes”, which often precede strokes. Despite advances in imaging , cardiac monitoring, patient history assessment, and clinical examination, the cause remains unknown (or “cryptogenic”) in up to 40% of ischemic strokes, representing 240,000 to 280,000 US cases each year. Of these 280,000 cryptogenic strokes, an estimated 72,000 will die within 1 year. Furthermore, a significant number of TIAs are oftened misdiagnosed or difficult to distinguish from mimics (migraines, seizures). Experiencing a TIA increases the risk of stroke by 20% within 90 days. Cause drives clinical outcomes and there are no blood tests for cause of stroke or TIA.  Over $40B is spent each year in the US on the diagnosis and treatment of stroke. Globally, imaging and other advanced techniques are not standard of care.

References

Wechsler. Role of Imaging in Acute Stroke Remains Blurry. Presented results of analysis at 37th Annual VEITH Symp. http://bit.ly/gHKnRM

Kizer JR., Evaluation of the patient with unexplained stroke. Coron Artery Dis. 2008 Nov;19(7):535-40. Review. PMID: 1892325

Latha Ganti Stead, et al., “Cardioembolic but Not Other Stroke Subtypes,” Stroke Research and Treatment, vol. 2011, Article ID 281496, 5 pages, 2011. doi:10.4061/2011/281496
 

Important take aways…