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Vol. 27. Núm. S1.
Aplicaciones de dabigatrán en neurología
Páginas 4-9 (marzo 2012)
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Vol. 27. Núm. S1.
Aplicaciones de dabigatrán en neurología
Páginas 4-9 (marzo 2012)
Aplicaciones de dabigatrán en neurología
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Ictus cardioembólico: epidemiología
Cardioembolic stroke: epidemiology
Visitas
17686
J. Díaz Guzmán
Unidad de Ictus, Servicio de Neurología, Hospital Universitario 12 de Octubre, Madrid, España
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Resumen

Aproximadamente, 1 de cada 4 ictus isquémicos es de origen cardioembólico. La fibrilación auricular no valvular representa el 50% de estos casos, seguida del infarto de miocardio, los trombos intraventriculares, las valvulopatías y una miscelánea de cardiopatías. La incidencia de cardiopatía embólica en la población podría estar en torno a 30 casos por 100.000 habitantes-año, y su prevalencia entre 5–10 casos por 1.000 personas de 65 o más años de edad. La mortalidad intrahospitalaria es elevada, y a los 5 años tan sólo 1 de cada 5 pacientes ha sobrevivido. La tasa de recurrencia de este tipo de ictus es aproximadamente del 12% a los 3 meses, más elevada que la de los ictus no cardioembólicos. La gravedad y discapacidad resultantes del ictus cardioembólico son importantes, mayores que las del no cardioembólico. La edad, los antecedentes de ictus o ataque isquémico transitorio previo, la hipertensión arterial, la diabetes y la insuficiencia cardíaca actúan en los ictus con fibrilación auricular como factores de riesgo añadido para futuras embolias, pudiendo alcanzar tasas de embolia de hasta más del 20% al año, por lo que su prevención y tratamiento son de suma importancia.

Palabras clave:
Ictus isquémico
Epidemiología
Fibrilación auricular
Cerebrovascular
Cardioembólico
Revisión
Abstract

Approximately one in four ischemic strokes is of cardioembolic origin. Non-valvular atrial fibrillation accounts for 50% of these cases, followed by myocardial infarction, intraventricular thrombus, valvular heart disease and a miscellany of causes. The incidence of embolic heart disease in the population could be about 30 cases per 100,000 inhabitants per year, and its prevalence between 5 and 10 cases per 1,000 persons aged 65 years or older. Hospital mortality is high, and 5-year survival is only one out of every five patients. The recurrence rate of this type of stroke is about 12% at 3 months, higher than that of non-cardioembolic stroke. The severity of cardioembolic strokes and the resulting disability are greater than with non-cardioembolic stroke. Age, a history of stroke or transient ischemic attack, hypertension, diabetes and heart failure play a role in stroke with atrial fibrillation as additional risk factors for future embolisms. Stroke rates can reach over 20% per year and therefore the prevention and treatment of these events are of paramount importance.

Keywords:
Ischemic-stroke
Epidemiology
Atrial fibrillation
Cerebrovascular
Cardioembolic
Review
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Copyright © 2012. Sociedad Española de Neurología
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