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{
    "pk": 18145,
    "title": "Cardiac Complications in Acute Ischemic Stroke",
    "subtitle": null,
    "abstract": "Introduction: To characterize cardiac complications in acute ischemic stroke (AIS) patients admitted from an urban emergency department (ED).\n\n\nMethods: Retrospective cross-sectional study evaluating AIS patients admitted from the ED within 24 hours of symptom onset who also had an echocardiogram performed within 72 hours of admission.\n\n\nResults: Two hundred AIS patients were identified with an overall in-hospital mortality rate of 8% (n¼ 16). In our cohort, 57 (28.5%) of 200 had an ejection fraction less than 50%, 35 (20.4%) of 171 had ischemic changes on electrocardiogram (ECG), 18 (10.5%) of 171 presented in active atrial fibrillation, 21 (13.0%) of 161 had serum troponin elevation, and 2 (1.1%) of 184 survivors had potentially lethal\n\n\narrhythmias on telemetry monitoring. Subgroup analysis revealed higher in-hospital mortality rates among those with systolic dysfunction (15.8% versus 4.9%; P ¼ 0.0180), troponin elevation (38.1% versus 3.4%; P , 0.0001), atrial fibrillation on ECG (33.3% versus 3.8%; P ¼ 0.0003), and ischemic changes on ECG (17.1% versus 6.1%; P ¼ 0.0398) compared with those without.\n\n\nConclusion: A proportion of AIS patients may have cardiac complications. Systolic dysfunction, troponin elevation, atrial fibrillation, or ischemic changes on ECG may be associated with higher inhospital mortality rates. These findings support the adjunctive role of cardiac-monitoring strategies in the acute presentation of AIS. [West J Emerg Med. 2011;12(4):414–420.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "stroke"
        },
        {
            "word": "heart"
        },
        {
            "word": "Echocardiogram"
        },
        {
            "word": "cardiology"
        },
        {
            "word": "Emergency Medicine"
        },
        {
            "word": "Neurology"
        }
    ],
    "section": "Cardiovascular",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/37t0w8w5",
    "frozenauthors": [
        {
            "first_name": "Charles",
            "middle_name": "R",
            "last_name": "Wira",
            "name_suffix": "",
            "institution": "Yale School of Medicine, Department of Emergency Medicine and Acute Stroke Service, New Haven, Connecticut",
            "department": "None"
        },
        {
            "first_name": "Emanuel",
            "middle_name": "",
            "last_name": "Rivers",
            "name_suffix": "",
            "institution": "Henry Ford Hospital, Department of Emergency Medicine and Surgical Critical Care, Detroit, Michigan",
            "department": "None"
        },
        {
            "first_name": "Cynthia",
            "middle_name": "",
            "last_name": "Martinez-Capolino",
            "name_suffix": "",
            "institution": "Henry Ford Hospital, Department of Emergency Medicine, Detroit, Michigan",
            "department": "None"
        },
        {
            "first_name": "Brian",
            "middle_name": "",
            "last_name": "Silver",
            "name_suffix": "",
            "institution": "Henry Ford Hospital, Department of Neurology, Detroit, Michigan",
            "department": "None"
        },
        {
            "first_name": "Gayathri",
            "middle_name": "",
            "last_name": "Iyer",
            "name_suffix": "",
            "institution": "Henry Ford Hospital, Department of Cardiology, Detroit, Michigan",
            "department": "None"
        },
        {
            "first_name": "Robert",
            "middle_name": "",
            "last_name": "Sherwin",
            "name_suffix": "",
            "institution": "Wayne State University, Department of Emergency Medicine, Detroit, Michigan",
            "department": "None"
        },
        {
            "first_name": "Christopher",
            "middle_name": "",
            "last_name": "Lewandowski",
            "name_suffix": "",
            "institution": "Henry Ford Hospital, Department of Emergency Medicine and Acute Stroke Service, Detroit, Michigan",
            "department": "None"
        }
    ],
    "date_submitted": "2009-11-11T08:00:00Z",
    "date_accepted": "2009-11-11T08:00:00Z",
    "date_published": "2011-05-27T07:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/18145/galley/9254/download/"
        }
    ]
}